Requisitions and Specimen Receipt/Assessment

Berkshire Medical Center
Fairview Hospital
Specimen Transport
Diagnostic specimens:
A diagnostic specimen is defined as any human material including but not limited to,
excreta, blood and its components, tissue and tissue fluids collected for the purpose of
diagnosis, but excluding live infected animals.
Diagnostic specimens resulting from medical practice and research are considered a
negligible threat to the public health.
Diagnostic specimens obtained from patients with suspected infectious diseases may
contain limited quantities of an infectious agent. There are very few agents that may be
the source of an infection as a result of a transport mishap. If exposure to the specimen
due to transport mishap could result in an infection, the diagnostic specimen must be
packaged, labeled and transported as an infectious substance. Diagnostic specimens
collected during an investigation of an outbreak of a serious disease of unknown cause
must be handled as infectious substances.
Local Surface Transport
Examples include transport of specimens from a doctor’s office/surgery to a laboratory,
from a hospital to a diagnostic laboratory or from one laboratory to another. Such courier
services may be operated by a hospital, a laboratory, a health service or other approved
agency or organization.
The principle of safe transport by this means is the same as for air or international
transport – the material should not have any possibility of escaping from the package
under normal conditions of transport.
The following practices should be observed:
1. All laboratory specimens should be transported in biohazard bags to the core lab.
 Vacutainer tubes
 Blood culture bottles
 Urine specimens
 Stool specimens
 Body fluid specimens
 Cytology & Pathology specimens
Place in zip-lock biohazard specimen transport bags. Specimen containers should be
watertight and leak-proof.
2. Place the requisition in the pocket of the biohazard bag.
3. Fold the requisition so that the patient information is to the inside and not visible
from the outside for confidentiality reasons.
4. Specimens should be stored at the proper temperature (See User Notes in the test
dictionary for specifics with regard to specimen collection and transport). Specimens
should be kept at Room Temp, Refrigerated or Frozen prior to pickup by the lab
5. Couriers will gather specimens from the collection stations and transport them to the
main lab. A hard-sided cooler is used to transport the specimens. Cold packs are
used to keep the specimens cool for transport. Freezer packs are used for frozen
specimens. Room temperature specimens are transported at ambient temperature.
6. The transport box should be secured in the transport vehicle
7. Each transport box should be labeled appropriately consistent with its contents
8. A spill kit containing absorbent material, a chlorine disinfectant, a leak-proof waste
disposal container and heavy-duty reusable gloves should be kept in the transport
Infectious Substances:
Transport according to the Basic Triple Packaging System
The system consists of three layers as follows:
1. Primary receptacle. A labeled primary watertight, leak-proof receptacle containing
the specimen. The receptacle is wrapped in enough absorbent material to absorb all
fluid in case of breakage.
2. Secondary receptacle. A second durable, watertight, leak-proof receptacle to enclose
and protect the primary receptacle. Several wrapped primary receptacles may be
placed in one secondary receptacle. Sufficient additional absorbent material must be
used to cushion multiple primary receptacles.
3. Outer shipping package. The secondary receptacle is placed in an outer shipping
package that protects it and its contents from outside influences such as physical
damage and water while in transit.
Specimen data forms, letters and other types of information that identify or describe the
specimen ad also identify the shipper and receiver should be taped to the outside of the
secondary receptacle.
In Case of Accident of Spill:
In case of an accident or spill:
 lab personnel should notify a laboratory supervisor.
 an incident investigation and report will follow.
 a lab accident form will be completed.
Packaging and Labeling of Lab Specimens for Identification of Materials
Specimens are transported in clear LAB-LOC (zip-lock) SPECIMEN BAGS.
They are marked with the biohazard label and are watertight and leak-proof.
Confidentiality of Transported Specimens:
Specimens collected from physician offices and from our collection stations are
transported by lab couriers and/or by transport personnel employed by the health system.
All employees of the health system are educated in and bound by confidentiality rules.
Specimens are transported in transport bags and are accompanied by a requisition that is
folded so that patient information is not visible from the outside of the container.
Specimens Transported Outside the Hospital System:
Refer to attached World Health Organization (WHO) guidelines for transporting
specimens outside the health system. See documentation from the commercial courier
services (i.e., Fed Ex) regarding issues related to transport of biohazardous material.
When specimens are collected and received at the collection stations, the specimens
qualify for a lab “batch list”. This batch list is the tracking mechanism built into the
Meditech system that follows or tracks specimens from one collection station to the core
lab for testing.
The batch list is checked against the specimens received at the core lab. Specimens are
“received” in the system to show that the specimen is now located at the main lab for
testing. The tracking system shows date, time of collection, person who collected and
received specimens and location at any point in time. If a specimen is not included in the
batch, main lab will call the collection station for resolve. Couriers are not involved in
the specimen tracking.
If there are occurrences with specimen transport from the offices to the main lab, a lab
liaison is employed to investigate these instances and resolve any issues.
This would involve problems with transport of the specimen or improper collection and
handling of specimens. The central processing desk and the section chiefs are in contact
with the lab liaison to educate offices on best practice issues.
Requisitions and Specimen Receipt/Assessment
Following HCFA regulations, to ensure documentation of physician orders, requisition
forms are sent to the physician offices to accompany outpatients to the laboratory. If the
practice prefers sending their "face sheet” from their practice with all pertinent patient
documentation noted, and the lab tests noted on this form, we will accept this type of
If a patient arrives without the form or other hard copy requisition, the physician’s office
is called and requested to FAX to the laboratory a completed BHS lab requisition form
for our records.
All of the following elements are included in the requisition:
1. Patient name
2. Sex
3. Date of Birth
4. Physician/Provider
5. Tests requested
6. Time and date of specimen collection when appropriate
7. Source of specimen, when appropriate
8. Diagnosis
Once received, this requisition is registered in the Admitting module of the hospital
computer system. The patient account number is used to order tests in the lab module.
This ensures appropriate specimen identification and accessioning.
Approved by:
Medical Director: R. L. Johnson, MD
Approved by:
Technical Director: T. Bills, FIMLS
Prepared by:
Cheryl Jenks MBA, MT(ASCP)
Adopted: 4-20-06
Reviewed: 2-13-12