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QS-Proc-5
Author : Dr Tom Hartley
Authorised by Drs Marsden & Vervaart
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PATHOLOGY SERVICES, ROYAL HOBART HOSPITAL
PRIMARY SAMPLE COLLECTION MANUAL
EXPIRES JANUARY 2013
CONTENTS
INTRODUCTION ................................................................................................................................ 6
LOCATION OF PATHOLOGY DEPARTMENT ............................................................................... 6
PATHOLOGY DEPARTMENT OPENING HOURS ......................................................................... 6
PATHOLOGY SERVICES WEBSITE ................................................................................................ 6
A Typical Response to a Specimen Requirements Enquiry ............................................................. 9
PHLEBOTOMY SERVICE................................................................................................................ 10
Phlebotomy Rounds : ...................................................................................................................... 10
Blood Specimens - Order of Draw.................................................................................................. 10
SPECIMEN COLLECTION PROCEDURE CHECKLIST ........................................................... 12
CENTEPATH SPECIMEN COLLECTION CENTRE ...................................................................... 13
LABORATORY REQUEST FORMS, SAMPLE BOTTLES AND CONTAINERS ....................... 13
General Information ........................................................................................................................ 13
Request Forms/Tests ....................................................................................................................... 13
Collector’s Identity and Collection Date and Time ........................................................................ 13
Clinical Notes.................................................................................................................................. 13
Urgency ........................................................................................................................................... 13
OUR REQUEST FORMS .................................................................................................................. 14
DELIVERY, PACKING, TRANSPORT AND POSTAL REQUIREMENTS OF PATHOLOGY
SAMPLES........................................................................................................................................... 15
Transport of Infectious or Suspected Infectious Samples............................................................... 15
Sample Packing and Transport : Health and Safety Issues ............................................................. 15
Sample Delivery within the Hospital .............................................................................................. 17
Sample Delivery from External Centres ......................................................................................... 17
Sample Security .............................................................................................................................. 17
REPORTING OF TEST RESULTS ................................................................................................... 17
Typical Example of Pathology Results as Seen in the DMR.......................................................... 18
Typical Example of Pathology Results as Seen in CIS ................................................................. 19
OBTAINING LABORATORY RESULTS BY PHONE ................................................................... 19
PATHOLOGY SERVICES DEPARTMENTAL TELEPHONE NUMBERS................................... 21
CRITICAL RESULTS POLICIES AND PROCEDURES................................................................. 21
Anatomical Pathology ‘Alert’ And ‘Critical’ Results .................................................................... 21
Clinical Biochemistry Including Special Chemistry ‘Alerts’ And ‘Critical’ Results ..................... 22
Coagulation ‘Alert’ And ‘Critical’ Results ..................................................................................... 22
Cytogenetics ‘Alert’ And ‘Critical’ Results ................................................................................... 22
Endocrinology ‘Alert’ And ‘Critical’ Results................................................................................. 23
Haematology ‘Alert’ And ‘Critical’ Results ................................................................................... 23
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Transfusion Medicine ‘Alert’ And ‘Critical’ Results ..................................................................... 23
Special Haematology ‘Alert’ And ‘Critical’ Results ...................................................................... 23
Microbiology And Serology ‘Alert’ And ‘Critical’ Results ........................................................... 23
Molecular Medicine ‘Alert’ And ‘Critical’ Results ........................................................................ 24
CORE LABORATORY : INTRODUCTION .................................................................................... 24
TRANSFUSION MEDICINE (Core Laboratory) .............................................................................. 25
Introduction ..................................................................................................................................... 25
Urgent Requests .............................................................................................................................. 25
Sample Tubes .................................................................................................................................. 25
Blood Product Pickup ..................................................................................................................... 25
Blood Product Disposal .................................................................................................................. 26
Policies and Documentation ........................................................................................................... 26
Enquiries 24/7 ................................................................................................................................. 26
HAEMATOLOGY (Core Laboratory) .............................................................................................. 26
Introduction ..................................................................................................................................... 26
Specimen Containers ...................................................................................................................... 26
Stability of Haematology Samples.................................................................................................. 26
Retrospective Testing...................................................................................................................... 26
Reporting Of Results And Result Enquiries ................................................................................... 27
Reference Ranges............................................................................................................................ 27
Haematology Advice ...................................................................................................................... 27
Haematology Clinic ........................................................................................................................ 27
COAGULATION (Core Laboratory) ................................................................................................. 27
Introduction ..................................................................................................................................... 27
Specimens ....................................................................................................................................... 27
Stability of Coagulation Samples.................................................................................................... 27
Retrospective requesting ................................................................................................................. 28
Reporting of Results and Result Enquiries ..................................................................................... 28
Telephoning Results........................................................................................................................ 28
Urgent Coagulation Advice ............................................................................................................ 28
Patients for Coagulation Review .................................................................................................... 28
Reference Values ............................................................................................................................ 28
CLINICAL CHEMISTRY (Core Laboratory)................................................................................... 29
Introduction ..................................................................................................................................... 29
Special Protocols ............................................................................................................................. 29
Sample Guide .................................................................................................................................. 29
Retrospective Testing...................................................................................................................... 29
Reference Ranges............................................................................................................................ 30
Post of Care Testing ........................................................................................................................ 30
MICROBIOLOGY ............................................................................................................................. 30
Introduction ..................................................................................................................................... 30
Out of Hours Emergency Requests ................................................................................................. 31
Tests Available Out of Hours ......................................................................................................... 31
Clinical Consultation ...................................................................................................................... 31
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General Guidelines on Microbiological Samples ........................................................................... 31
Sample Storage ............................................................................................................................... 31
Sample Retention Times ................................................................................................................. 31
Referred Tests ................................................................................................................................. 32
Special Investigations ..................................................................................................................... 32
Reporting of Results and Results Enquiries.................................................................................... 32
Turnaround Times ........................................................................................................................... 32
CYTOGENETICS .............................................................................................................................. 32
Laboratory Hours ............................................................................................................................ 33
Specimen Requirements And Tests ................................................................................................ 33
Reporting Of Results And Results Enquiries.................................................................................. 34
Turnaround Times ........................................................................................................................... 34
Urgent Requests .............................................................................................................................. 34
MOLECULAR MEDICINE ............................................................................................................... 35
Introduction ..................................................................................................................................... 35
Laboratory Opening Hours ............................................................................................................. 35
TESTS PERFORMED .................................................................................................................... 35
SPECIMEN REQUIREMENTS AND TEST NOTES ................................................................... 36
Cut-off Times for Sample Processing and Referral ........................................................................ 36
Laboratory Notification of Emergency Samples during Routine Hours ........................................ 37
Tests available outside of routine hours.......................................................................................... 37
Referred Tests ................................................................................................................................. 37
Results and Enquiries ...................................................................................................................... 38
Retention times ............................................................................................................................... 38
Retrospective requesting (Add on tests) ........................................................................................ 38
ENDOCRINOLOGY .......................................................................................................................... 38
Laboratory Opening Hours ............................................................................................................. 38
Tests performed Daily..................................................................................................................... 38
Tests performed weekly or twice weekly ....................................................................................... 39
Tests performed approximately every 2 or 3 weeks ....................................................................... 39
Tests performed approximately 6 – 8 weeks .................................................................................. 39
Referred Samples/Referred Tests ................................................................................................... 39
Special investigations/protocols...................................................................................................... 40
Cut-off Times for Sample Processing and Referral ........................................................................ 40
Storage conditions for samples ....................................................................................................... 40
Telephoning Results........................................................................................................................ 40
Turnaround times ............................................................................................................................ 40
Emergency On-Call ........................................................................................................................ 40
Laboratory Notification of Emergency Samples during Routine Hours ........................................ 41
Laboratory Notification of Emergency Work Outside of Routine hours ....................................... 41
Tests available outside of routine hours.......................................................................................... 41
Point of Care Testing (POCT) ........................................................................................................ 41
Reference Values ............................................................................................................................ 41
Repeat Samples ............................................................................................................................... 41
Reporting of Results and Result Enquiries ..................................................................................... 41
Retention times ............................................................................................................................... 41
Retrospective requesting (Add on tests) ........................................................................................ 42
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SPECIAL INVESTIGATIONS .......................................................................................................... 42
Laboratory Hours ............................................................................................................................ 43
On-Call Service ............................................................................................................................... 43
ANATOMICAL PATHOLOGY DEPARTMENT ............................................................................ 43
HISTOPATHOLOGY .................................................................................................................... 44
Laboratory Hours ............................................................................................................................ 44
On Call Service ............................................................................................................................... 44
Tests ................................................................................................................................................ 44
Collection of Samples ..................................................................................................................... 44
Notification of Results .................................................................................................................... 45
Urgent Samples ............................................................................................................................... 45
CYTOLOGY................................................................................................................................... 45
Laboratory Hours ............................................................................................................................ 45
On Call Service ............................................................................................................................... 45
Tests ................................................................................................................................................ 45
Collection of Samples ..................................................................................................................... 45
Gynaecological Cytology (Pap Smears) ......................................................................................... 45
Non-Gynaecological Cytology ....................................................................................................... 45
Fine Needle Aspiration Cytology ................................................................................................... 46
Notification of Results .................................................................................................................... 46
Urgent Samples ............................................................................................................................... 46
Mortuary ......................................................................................................................................... 46
SUPPORT FOR RESEARCH : SAMPLES AND PROTOCOLS ..................................................... 46
PROCEDURE ................................................................................................................................. 47
GUIDE TO THE ORGANISATIONAL STRUCTURE OF RHH PATHOLOGY SERVICES ....... 48
PATHOLOGY SERVICES STAFF PHONE NUMBERS ................................................................ 48
Senior Management ........................................................................................................................ 48
Pathologists ..................................................................................................................................... 49
Senior Staff ..................................................................................................................................... 49
PATHOLOGY SERVICES DEPARTMENTAL FAX NUMBERS .................................................. 50
QUALITY SYSTEMS ........................................................................................................................ 50
LABORATORY ACCREDITATION ................................................................................................ 51
EXTERNAL QUALITY ASSURANCE PROGRAMMES ............................................................... 51
Acknowledgements ............................................................................................................................. 54
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Authorised by Drs Marsden & Vervaart
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INTRODUCTION
This document was prepared to comply with the requirements of ISO 15189 Clauses 5.4.2 to 5.4.14
inclusive and Annex C all of Clause C.4.
LOCATION OF PATHOLOGY DEPARTMENT : Level 1, D Block, Royal Hobart Hospital
PATHOLOGY DEPARTMENT OPENING HOURS :
Core Laboratory
Comprises Biochemistry, Haematology, Coagulation and Transfusion Medicine
Operates 24 hours a day seven days a week.
Urgent samples only between the hours of 20:00h and 08:00h
Microbiology : 08:00h to 21:00h Monday to Friday
08:30h to 16:00h Weekends and Public Holidays
All other Departments : 09:00h to 17:30 Monday to Friday
PATHOLOGY SERVICES WEBSITE
http://intra.dhhs.tas.gov.au/dhhs-online/page.php?id=21753
This is an intranet web page and cannot be viewed on PCs outside of the DHHS web firewall. All
DHHS users are encouraged to use this webpage for the most up to date information and links into
important resources such as our specimen requirements database. If you are outside of the DHHS
firewall then much of this information is available via the Centrepath website
www.centrepath.dhhs.tas.gov.au
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Important online links are marked with arrows. The Test Information Database is the location of all
our Specimen Requirements information; Pathology Services does not produce a printed list of
specimen requirements because with the pace of technological changes in laboratory instruments and
assays such a list rapidly becomes out of date.
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A Typical Response to a Specimen Requirements Enquiry
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PHLEBOTOMY SERVICE
A team of specialist nurses who provide Phlebotomy Services throughout the RHH Wards and
Departments. They provide regular phlebotomy ward rounds on weekdays and a limited service on
weekend and public holiday mornings for essential samples only. They have special skills in blood
collection appropriate for acute care patients.
Phlebotomy Office
7955
Phlebotomy Courier
0488678582
Phlebotomy Mobile
Phlebotomy Mobile
Phlebotomy Mobile
Phlebotomy Mobile
0439069006
0447502262
0447543589
0447535870
Phlebotomy Rounds :
Weekdays : Rounds commence at 7:30, 11:00 and 13:00. The last round finishes by 14:45h
Weekends : Rounds commence at 7:30 and finish by 12:00.
Blood Specimens - Order of Draw
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QS-Proc-5
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___________________________________________________________________________________________________________
SPECIMEN COLLECTION PROCEDURE CHECKLIST
1. Carry out a Verbal Check of the patient’s
o Surname
o Given Name
o Date of birth
You must ask the patient to state these details and not prompt them at all.
If the patient is unable to give understandable verbal responses then you must check all these
details with a responsible ‘other’ person accompanying the patient
2. Compare these with the details on the Request Form(s) – THEY MUST ALL MATCH
ALSO Compare these details on the labels on any samples brought in by the patient.
COLLECT
3. Collect all the specimens and place them into their appropriate unlabelled tubes
4. Remove collection devices and make the patient comfortable.
LABEL
5. Label the specimen(s) with
o
o
o
o
o
UR Number
Surname
Given Name
Date of birth
Date and Time of Collection
NEVER LABEL TUBES BEFORE COLLECTING SPECIMENS
NEVER LEAVE FILLED UNLABELLED SPECIMEN TUBES UNATTENDED.
6. Stamp the Request Form with your ID Stamper and complete the Date and Time of
Collection box
7. Place the Request Form into the open compartment of the BioHazard Bag
8. Place the specimens into the sealable compartment of the BioHazard bag.
Some specimens need to be transported on ice or in a hot box or in a thermos – those
specimens should be placed into those containers instead.
DISPATCH
Arrange for the transport of the specimens to the Laboratories as soon as possible.
_____________________________________________________________________________________________________________
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CENTREPATH SPECIMEN COLLECTION CENTRE
In December 1999 we opened this dedicated Specimen Collection Service which is now on the
ground floor of the H Block (Gaha Wing). Further up to the minute details on this service are
provided via their website :
www.centrepath.dhhs.tas.gov.au
LABORATORY REQUEST FORMS, SAMPLE BOTTLES AND CONTAINERS
General Information
This section deals with the requirements for correct of labelling sample containers and Pathology
Request Forms
Request Forms/Tests
All Request Forms and Specimen Containers for Hospital Patients must have three points of
positive patient identification
UR Number
Surname and Given Name
Date of Birth
All Request Forms and Specimen Containers for Non-Hospital Patients must have two points of
positive patient identification
Surname and Given Name
Date of Birth
All combinations of incorrectly completed Request Forms and Specimen Contaners will be rejected
for testing. In exceptional circumstances, and only after direct consultation with a Pathologist,
incorrect Requests and Specimens will be processed. Even then they will only be reported as a
Deidentified Patient report.
Collector’s Identity and Collection Date and Time
All Request Forms must indicate the specimen collector’s identity and the date and time at which
they collected the specimen(s)
Clinical Notes
These are required but do not have to be extensive. They should include details that you consider
may affect the interpretation of the results of testing eg ‘Chronic alcoholic liver disease’, ‘Pre
dialysis sample’, ‘Resection of adhesions post abdominal radiotherapy’
Urgency
Writing ‘Urgent’ on a request form will have no effect on the speed with which we process that
sample. If a sample is truly Urgent then the laboratories must be advised by a phone call before the
specimen arrives in the laboratory. (NOTE : Specimens from ED, NICU and ICU are
automatically handled as Urgent samples)
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OUR REQUEST FORMS
We have six RHH Request Forms and two styles of Centrpath Pathology which can be easily
identified by their top coloured stripe design. Supplies are available from 6222 – 8657
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DELIVERY, PACKING, TRANSPORT AND POSTAL REQUIREMENTS OF
PATHOLOGY SAMPLES
Transport of Infectious or Suspected Infectious Samples
All specimens must arrive in the laboratory bagged or otherwise wrapped so that they cannot
contaminate any persons handling them or their environment. Upon opening all specimens are
handled in the laboratory as though they are infectious. That means we use appropriate Universal
Precautions – gloves, gowns and eye protection.
Sample Packing and Transport : Health and Safety Issues
Adequate packaging and transport of specimens is the responsibility of the specimen collector’s
Ward, Unit or Practice. It is their responsibility to ensure that their specimens are packed and
dispatched in a way that there is no Health or Safety risk to persons handling them between the point
of collection and the Specimen Receipt area of our laboratories.
Blood and fluid samples are best packed into the usual two compartment ‘zip’ plastic bags. The
specimens should be placed into the ‘zip’ compartment and the Request Form into the pocket
compartment. Specimen containers should have their lids screwed on tightly. Any leakage or
contamination of the outside of the tube must be wiped off with an appropriate disinfectant or
alternatively decanted into a fresh plain tube. Decanting an ‘additives’ specimen into a fresh clean
‘additives’ tube will nullify the results on that specimen because in effect the specimen will have
been exposed to double the quantity of additive. If the Request Form has been splashed with
specimen material then this this should be wiped off and the contaminated area covered with clear
adhesive tape – front and back. Alternatively a fresh Request Form can be completed or the original
can be photocopied and that sent along with the original that is completely sealed in a plastic bag..
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SPECIMENS THAT ARRIVE IN THE LABORATORY THAT HAVE CLEARLY LEAKED IN
TRANSIT WILL NOT BE PROCESSED.
All our Specimen Tubes are high impact plastic, however, the Blood Culture bottles are all glass.
They are fairly robust however they must be wrapped in bubble wrap or similar if they are to be
transported via the Vacuum Tube System (Ferrets) or by vehicle in from outside the Royal Hobart
Hospital.
All specimens that are to be transported from locations outside the Royal Hobart Hospital must be
transported inside a esky with a cold ‘chill’ block. The esky must be placed in the vehicle securely
so that it does not slide around the vehicle and be shaded at all times from direct sunlight. Eskies
containing specimens must not be left in locked or unattended vehicles. As a rule of thumb most
blood specimens do not retain their integrity for longer than four hours after collection; if this
is a problem please contact the laboratory and we will advise you as to what preprocessing of
the specimens would be appropriate before you dispatch them via a vehicle. Transport of
pathology specimens via aircraft are subject to strict IATA Regulations. We can assist with advising
you about air transport of pathology specimens.
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Some specimens require special handling eg at 37 degrees centigrade or with minimal vibration eg
platelet aggregation samples. These details are outlined in the Specimen Requirements database for
those tests as well as the telephone numbers you need to call, usually before you take the
specimen(s), so that the laboratory can prepare to receive these special samples.
Sample Delivery within the Hospital
The preferred method of delivery of appropriately bagged ‘tube’ specimens is via the Vacuum Tube
(ferret) system of the Royal Hobart Hospital.
Large specimens such as 24 hour urines and faeces and surgical specimens will need to be hand
delivered to the laboratory.
Sample Delivery from External Centres
Our preferred contractor is Mini Messenger. If your Clinic or Practice telephones us we can arrange
for them to pick up specimens.
Sample Security
Specimens must always be kept in a secure area until they are dispatched. Our specimen receipt and
storage procedures do not meet the ‘chain of custody’ requirements. This means that our results do
not meet the requirements for ‘forensic evidence’. However, where a patient becomes the subject of
a legal case then the laboratory should be advised as soon as possible as we may be able to
quarantine the specimen material we still retain.
AS A GENERAL RULE, TUBE TYPE SPECIMENS ARE ONLY RETAINED FOR SEVEN
DAYS POST ANALYSIS.
REPORTING OF TEST RESULTS
Electronic reporting into the DMR, CIS and GP Practice systems is now the norm. A4 printed
reports and faxed reports are also produced as soon as the results have been authorised by the
Pathologists or Medical Scientists.
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Typical Example of Pathology Results as Seen in the DMR
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Typical Example of Pathology Results as Seen in CIS
OBTAINING LABORATORY RESULTS BY PHONE
Staff are requested to keep their phone calls for results to a minimum. As soon as results are
authorised or interimed on our computer system they are immediately transmitted into the Digital
Medical Record. So if you cannot see the results you are after in the DMR or CIS then they are not
available. The majority of our GP clients have opted for electronic reporting via the GP system.
Again we feed electronic reports into that system as soon as they are ready. The Table below gives
you an outline of our automated call handling menu :
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PATHOLOGY SERVICES DEPARTMENTAL TELEPHONE NUMBERS
Specific Contacts
( when dialling from outside RHH add 6222 in front of extension number)
CPU (Central Processing Unit)
8416
Specimen Reception
8619
Urgent Samples Only
8331
Centrepath
3058 / 7121
Pathology Administration
8410
Pathology Stores
8347
Phlebotomy Office
Phlebotomy Courier
0488678582
0439069006 Phlebotomy Mobile - NSU, 6A, 5
0447535870
0447502262 Phlebotomy Mobile - TCU/GEM
0409565548
0447543589 Phlebotomy Mobile - TCU/GEM
0407872797
7955
Phlebotomy Mobile - 1BS,
1BN, 2BS
Phlebotomy Mobile - 2DS,
2DC, 2A
Phlebotomy Mobile - MAPU,
ASU, 2BS, Dwyer
Anatomical Pathology
Biochemistry
Cytogenetics
Cytology
Endocrinology
Flow Cytometry
Haematology
8770
8775
8297
8235
8781
8913
8776
Immunology/Special Haematology
Microbiology
Molecular Medicine
Serology
Special Chemistry / Investigations
Stem Cell Transplant
Transfusion / Bloodbank
8774
8417
8912
8777
8742
8744
8411
CRITICAL RESULTS POLICIES AND PROCEDURES
Anatomical Pathology ‘Alert’ And ‘Critical’ Results
Results from Anatomical Pathology cases are not regarded as ‘Critical’ or ‘Alert’;
Results on samples classed as ‘Urgent’ are handled in one of the two following methods:

Frozen Section
o The clinician/surgeon in charge of a patient calls the Anatomical Pathology department
before the surgery to inform the department of the impending specimen.
o The sample is taken and sent to the laboratory for analysis and Anatomical Pathologist
phones the surgeon with the result.
o The result, the date and time the result is phoned to the surgeon and the name of the
surgeon and/or person taking the message are recorded on the ‘Frozen Section Report
Record’ by the reporting Anatomical Pathologist. Refer to Document 160 for full details
of the procedure.

Samples requiring urgent processing or urgent reporting, but not a frozen section, will have notes
written on the request form indicating the urgency of the result
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o The requesting clinician will contact the Anatomical Pathology department to request that
a sample is reported urgently, or both.
o The reporting Anatomical Pathologist will attempt to call the clinician directly only if the
clinician has requested direct contact and contact details have been provided.
o The reporting Anatomical Pathologist will note in the report if this contact is made.
Clinical Biochemistry Including Special Chemistry ‘Alerts’ And ‘Critical’ Results
< Value
> Value
Units
Chemistry
Sodium
Potassium
Glucose
Calcium
Magnesium
Creatinine
120
155
2.5
6.0
2.5
20.0
1.90
2.90
0.50
3.00
>10% or significant change
within a short period
0.3
Troponin
mmol/L
mmol/L
mmol/L
mmol/L
mmol/L
mol/L
g/L
Any results outside these ranges will be checked and phoned through to the ward or doctor
immediately.
An exception to the rule occurs if there is prior knowledge of any existing condition with serial
abnormal results.
Coagulation ‘Alert’ And ‘Critical’ Results
Coagulation Results WILL be phoned in each instance when;


The INR is >4.5 (Warfarin Patients)
The APTT is >90 sec (Heparinised Patients)
For first time patients where;




The INR is >1.5 (Non Warfarinised Patients)
The APTT is >40 sec (Non Heparinised Patients)
The Fibrinogen is <1.5 g/L
Any abnormal Coag test pre-operatively (unless pre-admission clinic)
Cytogenetics ‘Alert’ And ‘Critical’ Results

A positive t(15;17) or one of the recognised variants, associated with APML must be phoned
through to the Requesting Doctor
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Endocrinology ‘Alert’ And ‘Critical’ Results
Analyte
Normal Range
138-690 nmol/L
Cortisol
FT3
FT4
TSH
2-6 pmol/L
10-24 pmol/L
0.4-4 mU/L
Critical Value Alert
<50 if not having a
Dexamethasone
Suppression Test or a
Metapyrone Suppression
Test
>15 (if new patient)
>40 (if new patient)
>30 if not recognised
hypothyroid or not on
Thyrogen stimulation
Haematology ‘Alert’ And ‘Critical’ Results
WCC:
Hb:
MCV:
HCT:
PLT:
>40 X 109/L
<1.0 X 109/L
>190 g/L
<70 g/L
>115 fL
>65 L/L
>1000 x 109/L
<50 x 109/L
Transfusion Medicine ‘Alert’ And ‘Critical’ Results
Delays in provision of blood products, either due to supply issues or antibodies will be phoned to the
Requesting Doctor.
Special Haematology ‘Alert’ And ‘Critical’ Results
Any POSITIVE MALARIA sample will be phoned through to the Requesting Doctor
Microbiology And Serology ‘Alert’ And ‘Critical’ Results
Organism or specimen
type
Lab to notify ward
(or requesting
doctor) directly
Urgent samples (as
requested by requesting
Dr)
Abnormal CSFs
Sterile site isolates
MRSA (new isolate)
VRE (new isolate)
MRGN (new isolate)
C. difficile
√
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√
√
√
√
Lab staff to notify
ID registrar (BH)
or ID physician oncall (AH)
√
√
√
√
√
√
Authorised by Drs Marsden & Vervaart
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Rotavirus
Influenza serology pos
Adenovirus
AFB and/or
Mycobacteria spp.
cultured
HIV
Acute Hep B
Acute Hep A
√
√
√
√
√
√
√
Molecular Medicine ‘Alert’ And ‘Critical’ Results
Organism or specimen
type
Lab to notify ward
(or requesting
doctor) directly
Urgent samples (as
requested by requesting
Dr)
Positive results from
CSFs
Positive results from
Sterile site isolates
Influenza
Adenovirus
MTB PCR positive
All NPA results
√
Lab staff to notify
ID registrar (BH)
or ID physician oncall (AH)
√
√
√
√
√
√
√
√
CORE LABORATORY : INTRODUCTION
This includes Clinical Biochemistry, Coagulation, Haematology, Transfusion Medicine. It is also the
location of the Central Specimen Receipt and Processing Unit, (CPU).
This laboratory provides the critical care and automated services to the RHH, the Hobart Private
Hospital, Clinics and General Practitioners. These services include the routine investigations
associated with










QS-Proc-5
Full Blood Examination
Haematomorphology
Routine Coagulation tests
Coagulation Factor assays
Hypercoagulability testing
Platelet Function studies
Routine Biochemistry - electrolytes, liver function tests, amylase,
calcium and magnesium
Lipids
Cardiac Markers
Therapeutic Drug Monitoring
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





Drugs of Abuse Screening tests
Arterial Blood Gases and Electrolytes
Near Patient Testing Instrumentation support
Routine Blood Transfusion Services including Antenatal Screening
Provision of blood and blood products
Red Cell Antibody Identification
The laboratory features modern instrumentation and is highly computerised with on-line data
acquisition and electronic reporting. The services are offered 24 hours a day, 365 days a year.
Routine Tests are completed with as short as possible turn around times within the laboratory to
meet their aim of providing Clinical Staff with the rapid and reliable information that they require
for their patients' management.
The laboratory also coordinates the maintenance, general support and user training for the Near
Patient Testing equipment in the RHH Departments of Emergency Medicine, Adult Intensive Care,
Neonatal Intensive Care and the Cardiothoracic Operating Theatre.
_________________________________________________________________________________
TRANSFUSION MEDICINE (Core Laboratory)
Introduction
The Transfusion laboratory has an automated analyser that allows for high volume throughput of
samples for blood group and antibody screens. Blood is issued via a computer crossmatch that
allows for almost instantaneous issue of blood in the absence of a positive antibody screen. The
transfusion laboratory is supported by highly skilled scientists, transfusion Nurse Consultant and
haematologists.
Urgent Requests
For urgent samples please phone the laboratory or just indicate on the request form the date and time
your products are required. Completion of pager or phone numbers will allow for smooth
communication if required.
If blood is required urgently and you are unable to wait for compatible blood emergency O negative
blood can be issued – please contact the laboratory.
Sample Tubes
Preferred samples are 9ml EDTA samples but any EDTA sample is acceptable provided that the
label is handwritten and that the collector and witness sign the transfusion Medicine Request form.
Blood Product Pickup
To collect blood products from the laboratory the collector must carry their own and patients identity
with them. Laboratory staff is on hand to assist in the collection of products.
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Blood Product Disposal
Products that have been used can be disposed of into the Medical waste bins on each ward. If for
some reason the product has not been used for a patient please contact or return the product to the
laboratory.
Policies and Documentation
For queries regarding the transfusion and documentation of transfusion see the intranet or blood
products folders available on each ward or call the Transfusion Nurse consultant.
Enquiries 24/7
Haematology staff are available 24/7 to guide and advise on appropriate product usage and dosing.
_________________________________________________________________________________
HAEMATOLOGY (Core Laboratory)
Introduction
The Haematology Laboratory is highly automated and uses state of the art dual Sysmex EX5000
analyzers and a SP1000i slide maker. A combination of automated flagging and sample source
criteria are used to refer blood films for manual review by Medical Scientists and Haematologists.
Currently about 25% of our daily workload undergoes manual film review.
Specimen Containers
Pink top EDTA tubes for FBCs, black rubber tops for ESRs, blue top citrate tube for platelet counts
on patients known to have persistent clotting abnormalities. Patients who are cold agglutinin positive
have to have their haematology specimens transported in a special ‘hot box’ which maintains the
specimens at 37°C. Contact 6222 8776 to arrange for the ‘hot box’ specimen pick up.
Stability of Haematology Samples
TESTS
FBC
Differential
ESR
Blood Film
Monospot
Reticulocyte count
SAMPLE STABILITY
TIMELINES
Up to 24 hours
Up to 24 hours
Up to 48 hours
Retrospective Testing
All samples are retained for at least seven days post receipt. Retrospective testing can only be
performed within the Stability Timelines given above.
Clinically significant blood films are retained for at least twelve months.
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Reporting Of Results And Result Enquiries
Our systems are all online to the Digital Medical Record and Computerised GP Reporting Systems.
As soon as results are authorised by a Scientist or Haematologist they are downloaded into those
systems. Consequently it should not be necessary for you to have to call the laboratory for results.
Hard copy reports are also provided for those requestors that require them.
Reference Ranges
All printed and electronic reports are provided with the reference range appropriate for the age,
gender and pregnant/non-pregnant situations.
Haematology Advice
During normal week day hours contact the Haematology Registrar. Out of hours and at weekends
contact the On-Call Haematologist via the RHH Switchboard.
Haematology Clinic
The RHH Specialist Clinics run the Haematology/Oncology Specialist Clinic every Wednesday.
_________________________________________________________________________________
COAGULATION (Core Laboratory)
Introduction
The Department has two automated analysers for performing routine and specialised Coagulation
testing; a Siemens CA-1500 optical clot detection system which is the primary analyser for routine
Coagulation (PT, INR, APTT and Fibrinogen) and a STAGO STA Compact mechanical clot
detection analyser which is used for Factor assays, Thrombophilia testing, Von Willebrands testing
and LMWH levels. The STA Compact is also the back –up analyser for routine testing during
downtime for the CA-1500.
The department also performs HITTS testing using Diamed PaGIA – (Particle Gel Immuno Assay)
and platelet function testing with a PFA-100 and Chronolog Platelet Aggregometer.
Specimens
Freshly obtained patient blood is collected via venepuncture into 2ml or 4ml blue top tubes
containing an appropriate volume of 3.2% buffered sodium citrate anticoagulant. Tubes must be
mixed gently as soon as possible after collection and transported to the laboratory at room
temperature.
Note – any sample tubes that have not been filled with blood to the ml or 4ml line marked on the
tube are rejected.
Stability of Coagulation Samples
TEST
QS-Proc-5
SAMPLE STABILITY TIMLINES
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FROM COLLECTION
PT/INR
Up to 6 hours at RT.
APTT
If on heparin within 2 hours
D-Dimer
Up to 8 hours at RT.
Fibrinogen
Up to 24 hours if refrigerated (2-8oC)
Up to 6 hours at RT
Retrospective requesting
Add on testing for Coagulation can be done within the time lines above.
Reporting of Results and Result Enquiries
Our systems are all online to the Digital Medical Record and Computerised GP Reporting Systems.
As soon as results are authorised by a Scientist or Haematologist then they are downloaded into
those systems. Consequently it should not be necessary for you to have to call the laboratory for
results. Hard copy reports are also provided for those requestors that require them.
Telephoning Results
Patient results will be notified to the Ward staff or Requesting Doctor when a significant change has
occurred, or where the patient may be at risk of bleeding. Triggers that initiate a telephoned result
include :
The INR is > 4.5 (Warfarin Patients)
The APTT is > 90s (Heparinised Patients)
For first time patients where;
• The INR is > 1.5 (Non Warfarinised Patients)
• The APTT is > 40 sec (Non Heparinised patients)
• The Fibrinogen is < 1.5 g/L
• Any abnormal Coag test pre-operatively (unless pre-admission clinic)
Urgent Coagulation Advice
Consult Senior Scientist and / or Haematologist.
Patients for Coagulation Review
Abnormal results are interim / verified by a Haematologist
Reference Values
All printed and electronic reports are provided with the appropriate reference ranges for the patients
gender, age and clinical condition.
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CLINICAL CHEMISTRY (Core Laboratory)
Introduction
The Clinical Chemistry Laboratory is highly automated and uses state of the art dual Abbott
Architect Ci8200 analyzers. They are fully interfaced to our laboratory computer system which
automatically authorises results which are normal. This leaves the operators more time to focus upon
specimens with abnormal results. The analysers also detect out of range results and automatically
retests the sample in dilution.
Special Protocols

Samples for BNP analysis must be collected into a pink top tube within four hours of
the onset of symptoms.

Samples for lipid studies are best collected from fasting patients.

Samples for the diagnosis of diabetes must be collected from fasting patients.

Samples for drug overdose prognosis should not be collected earlier than 4 hours post
overdose. Samples collected before 4 hours are only useful for drug identification.

Requests for serum aminoglycosides should be accompanied by the Pharmacy request
form for aminoglycosides. This form provides spaces for you to fill in the additional
data essential for the ‘area under the curve’ pharmacokinetic calculation.

Samples for Therapeutic Drug Monitoring must be collected just prior to the next
dose.
Sample Guide
Group 1 : The following tests can be performed on a single Red Top
4mL SST tube
AFP (alpha Foetoprotein)
Alcohol
alpha 1 antitrypsin
Amikacin
Amylase
B12/folate
C3, C4
CA-125
C-reactive protein (CRP)
CK
Caeruloplasmin
Calcium group
Carbamazepine
CEA
Cholesterol &
Triglyceride
Retrospective Testing
QS-Proc-5
Cholinesterase
Digoxin
Ferritin
Gentamicin
Haptoglobin
HCG
HDL
IPG
Iron (Iron
Studies)
LDH
LFT
Lipase
Lithium
Methotrexate
Osmolality
Paracetamol
Phenobarb
Procalcitonin
Phenytoin
PSA
Rheumatoid
Factor
Salicylate
Theophylline
Tobramycin
Transferrin
Tricyclics
Troponin
U&E
Urate
Valproate
Vancomycin
SST 4mL (Red top with gel)
Serum, urine and fluid samples are retained for seven days.
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Reference Ranges
All printed and electronic reports are provided with the appropriate reference ranges for the patients
gender, age and clinical condition.
Post of Care Testing
The laboratory supervises the quality control, maintenance and staff training of four blood gas
analysers located in the clinical areas. These analysers are located in the Emergency Department,
Intensive Care Unit, Neonatal Intensive Care Unit and Cardiothoracic Theatre.
Location
ICU
ED
NICU
THEATRE
Na K Cl
√ √ √
√ √ √
√ √ √
√ √ √
Ca2+
√
√
√
√
Analytes Measured
Glucose Lactate Creat. Bili pH PO2 pCO2
√
√
√
X
√
√
√
√
√
X
X
√
√
√
√
√
X
√
√
√
√
√
√
X
X
√
√
√
Hb
√
√
√
√
There are also four Haemoglobin Alc analysers; one in RHH Specialist Clinics and three in the
Diabetes Educators Department.
_________________________________________________________________________________
MICROBIOLOGY
Introduction
This includes Viral Serology, Infectious Diseases and Sexual Health Services
The Microbiology Laboratory supports clinicians managing patients with infections by isolating,
identifying and characterising micro-organisms causing disease.
A variety of methods are used including



direct microscopy,
culture,
serology
The laboratory has particular expertise in diagnostic molecular biology and is the Statewide
Reference Laboratory for HIV and Hepatitis C testing.
The laboratory works in close collaboration with Public Health and Infection Control Services when
and where necessary.
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Out of Hours Emergency Requests
Contact the Medical Scientist on Call via the RHH Switchboard if the specimen is a CSF. Requests
for urgent tests on other specimen types must first be approved by the On Call Medical
Microbiologist.
Tests Available Out of Hours
CSF samples will be processed out of hours but all other requests require the prior approval of the
On Call Medical Microbiologist.
Clinical Consultation
Contact the Medical Microbiology Registrar during normal hours or the On Call Medical
Microbiologist if out of hours.
General Guidelines on Microbiological Samples
Microbiology results depend critically on the type and the quality of the material received. Therefore
this material should be both representative and fresh. Meticulous adherence to sterile technique
during blood culture and fluid collections is essential. Appropriate cleansing and partial voiding
during urine collections is also essential.
All samples should have their container lids securely tightened prior to transportation to ensure safe
arrival in the laboratory. Package all samples in zip lock bags before being sent through the
Pneumatic Tube System (PTS).
Blood culture bottles need to be wrapped in bubble wrap or similar padding before sending through
the PTS.
Sample Storage
Local storage of microbiology samples is not recommended. All samples should be delivered as
soon as possible to Pathology Services Specimen Reception. The 24 hour staff there will ensure that
they are placed in a refrigerator or incubator as appropriate.
Sample Retention Times
Urine
Swabs
Fluids
Faeces
Sputums
CSF
Serum for Serology
TB samples
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7 days
14 days
5 years
2 months
Authorised by Drs Marsden & Vervaart
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Referred Tests
We do refer some tests to other laboratories for testing. We only do this for those samples for which
we lack the appropriate instrumentation/techniques or which are received in very low numbers per
year. The majority of our samples are referred to the Victorian Infectious Diseases Research
Laboratory (VIDRL).
Special Investigations
We only process post vasectomy semen samples. Semen samples for fertility testing have to be
collected at and tested by Hobart Pathology
Reporting of Results and Results Enquiries
Our systems are all computerised and online to the Digital Medical Record and Computerised GP
Reporting Systems. As soon as results are authorised by a Scientist or Microbiologist then they are
downloaded into those systems. Consequently it should not be necessary for you to have to call the
laboratory for results. Hard copy reports are also provided for those requestors that require them.
HIV testing results are only issued in hard copy.
Turnaround Times
M, C and S
Serum Serology
TB testing
:
:
:
48 to 72 hours
1-7 days
2-8 weeks
_________________________________________________________________________________
CYTOGENETICS
Cytogenetics is the study of chromosome structure, function and pathology. Cytogenetic studies are
used for diagnostic purposes in three main areas of medicine:



Constitutional karyotyping for congenital disorders.
Prenatal diagnosis.
Leukaemia diagnosis and prognosis and other cancers.
The cytogenetics laboratory at the Royal Hobart Hospital performs constitutional cytogenetics on
peripheral blood from patients suspected of having a congenital chromosome abnormality. Such
patients may include adolescents with late onset of puberty or adult couples experiencing infertility
or recurrent miscarriage.
Cytogenetic studies are also performed on cells from bone marrow where leukaemia is suspected and
on cells from solid tumours. In cancer, particularly in leukaemia and lymphomas, the cytogenetic
findings may be diagnostic or provide prognostic information important for the clinical management
of the patient.
Prenatal testing is referred to the Victorian Clinical Genetics Service (VCGS) in Melbourne.
Amniotic fluid and chorionic villus karyotyping is performed between 12 – 18 weeks gestation in
order to obtain a fetal karyotype. Prenatal diagnosis is generally performed in high risk pregnancies
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including patients with previous abnormal pregnancies, advanced maternal age, abnormal ultrasound
or adverse risk associated with biochemical screening.
Molecular karyotyping (microarray) is performed by VCGS and is primarily used to indentify
cytogenetic abnormalities in children or infants with dysmorphic features, developmental delay and
autism spectrum disorders including Aspergers syndrome.
Laboratory Hours
08:30 – 17:00 Monday to Friday
For after hours information please contact the Haematologist on call via the Royal Hobart Hospital
switchboard.
Specimen Requirements And Tests
Specimen requirements are all detailed in the online Specimen Requirements database described in
the general information section of this Users Guide.
Because we require fresh viable cells for Cytogenetic study, specimen material should be kept at
temperatures not exceeding 25°C or less than 4°C. Transport must be by the quickest means
available.
Never place tissue into formalin or freeze any sample that requires cytogenetic testing.
Please refer to the table below for testing and sample requirements.
Test
Requirements
Routine
Testing
Results
Bone Marrow
Cytogenetics
1.0mL heparinised bone
marrow (green lithium
heparin tube)
Adults: 5mL peripheral
blood in green lithium
heparin tube
Child: 1-5mL as above
Fresh sample to be received
in transport media (available
from the laboratory) or
sterile isotonic saline
No extra sample required if
referred with standard
cytogenetics/karyotyping.
For standalone FISH please
contact the laboratory.
15-20ml aseptically
collected.
Monday –
Thursday 08301700
Monday – Friday
0830-1700
5 – 18 days
Monday – Friday
0830-1700
5 – 18 days
Monday – Friday
0830-1700
5 – 18 days
Must be received
in the laboratory
by 2.00pm
Thursday. Will
not be sent on
Usually within 10
days of receipt of
sample.
Peripheral Blood
Karyotype
Tumour and Lymph
Node Biopsies
FISH testing
Amniotic Fluid
Karyotype (Referred
Test)
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Chorionic Villi
Karyotype (Referred
Test)
15-20mg of aseptically
collected villi (minimum
5mg)
Fetal Tissue /
Products of
Conception
Karyotype
(Referred Test)
Fresh placental biopsy (villi,
cord etc) or fetal tissue to be
received in transport media
(available from the
laboratory) or sterile
isotonic saline.
Do not freeze or place in
formalin.
Adults: 5mL peripheral
blood in EDTA tube
Child: 1-5mL as above
DNA Tests –
Including Fragile X,
Prader
Will/Angelman
syndromes and UPD
studies.
(Referred Test)
Microarray –
Molecular
Karyotype
(Referred Test)
Adults: 5mL peripheral
blood in EDTA tube
Child: 1-5mL as above
*Consultant signature
required for this test*
Fridays.
Must be received
in the laboratory
by 2.00pm
Thursday. Will
not be sent on
Fridays.
Monday –
Thursday 08301700
Usually within 10
days of receipt of
sample.
Usually within 34 weeks.
Monday –
Thursday 08301700
Usually within 34 weeks.
Monday –
Thursday 08301700
Usually within 34 weeks.
Reporting Of Results And Results Enquiries
Our systems are all computerised and online to the Digital Medical Record and Computerised GP
Reporting Systems. As soon as results are authorised by senior scientists they are downloaded into
those systems. Hard copy reports are also provided for those requestors that require them. For result
enquiries please contact the laboratory on 6222 8297.
Turnaround Times
Because we use culture techniques before analysis is performed, our turn around times are
necessarily longer, typically 9 to 14 days for routine specimens. Urgent requests can be processed
within 5 days provided there are no technical complications.
Urgent Requests
Specimens from neonates aged <2 months and all newly presenting leukaemia patients are handled
as ‘Urgents’. Other specimens are only handled as ‘Urgents’ when classified as such by our
Pathologist.
_________________________________________________________________________________
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MOLECULAR MEDICINE
Introduction
The molecular basis of most human disease is being revealed by scientific and technical advances in
the fields of molecular biology, genetics and recombinant DNA technology. Modern molecular
diagnostics in this laboratory is directed towards three areas :



Infectious Diseases
Markers of neoplastic diseases
Diagnosis of Inherited Disorders and the detection of carrier status.
Molecular Pathology Testing is playing an increasingly important role in routine patient
management; from initial diagnosis through to monitoring response to specific therapies.
The Molecular Diagnostics Laboratory uses progressive technologies and procedures to evaluate
infectious disease and inherited disorders and specific studies of T-& B-cell receptor/gene
rearrangement assays,
Laboratory Opening Hours
8:30 – 17:30 weekdays only.
TESTS PERFORMED
Genetic studies
- Factor V Leiden
- Prothrombin Gene (Factor II)
- Haemochromatosis
Malignancy studies
- T&B cell rearrangement
Infectious Disease studies - Hepatitis C PCR (qualitative)
- Chlamydia PCR
- CMV PCR
- VZV PCR
- Herpes Simplex Virus types 1 and 2 PCR
- Bordetella pertussis PCR
- Respiratory Virus Multiplex PCR
(Includes Influenza A/B, RSV, Parainfluenza, Adenovirus,
Picornavirus)
H1N1 INFLUENZA CONFIRMATION
-VRE PCR
-Neisseria meningitidis PCR
- Human papilloma virus PCR
Fibroblast culture for metabolic studies
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SPECIMEN REQUIREMENTS AND TEST NOTES
Please note that molecular testing requires a dedicated sample. If this is not possible, please
call the laboratory to discuss as once the specimen has been processed by another area of
Pathology, we are unable to use for Molecular testing.
Genetic studies
5mL EDTA blood (pink top
Malignancy studies
5mL EDTA blood (pink top).
Infectious Disease studies
Hepatitis C PCR -10mL serum (white/red top). Performed once weekly.
Chlamydia PCR - 1st pass urine (sterile urine container) or urogenital swab (white top
swab). Performed daily.
CMV PCR - 5 mL EDTA blood (pink top), BAL or fluid from sterile site (sterile
container). Performed as required.
Herpes Simplex and Varicella Zoster virus PCR - fluid from lesion swabs, sterile site
or CSF (sterile container).
Performed as required.
Bordetella pertussis PCR - NPA, nasopharyngeal swab collected in respiratory
transport media. Performed as required.
Respiratory Virus PCR - Respiratory samples: sputum, BAL,BW (sterile container),
NPA, deep nose and throat swabs (respiratory virus collection kits). Performed as
required.
VRE PCR- isolate only
Neisseria meningitidis PCR - EDTA blood (pink top), CSF or isolate. Performed as
required.
Human papilloma virus PCR
Cut-off Times for Sample Processing and Referral
All samples for molecular testing require certain processing procedures to be followed. This takes a
fixed amount of time that cannot be changed without affecting results. Therefore, urgent testing must
be discussed with the laboratory prior to collection and must be received by midday at the latest if a
same day result is to be attempted (where possible). All samples for tests that require referral to
another laboratory (see table) must be received by midday on Thursday.
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Author : Dr Tom Hartley
Authorised by Drs Marsden & Vervaart
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Laboratory Notification of Emergency Samples during Routine Hours
All significant results will be phoned to the ward during working hours. Notifiable diseases will be
reported to Communicable Diseases Prevention Unit in Public Health. RHH Infection Prevention
and Control Unit are notified if an infection requiring additional precautions is identified. .
Tests available outside of routine hours.
Molecular testing is unavailable outside routine hours. Problems or queries should be directed to a
Molecular staff member (mobile number 0438363219). Please leave a message if no answer on this
number as Molecular Biology does not have an on-call roster. For urgent testing outside of these
hours, please contact the clinical microbiologist on call via switch.
Referred Tests
The laboratory performs tests for which a sufficient throughput of requests is obtained to maintain an
efficient, cost-effective service. For low volume tests that are not performed locally, specimens are
referred for testing by external laboratories. These are included belowTest
Viral Load:
HIV
HCV
CMV
HIV Genotype
Write recent HIV viral
load result on form
otherwise one should be
requested. Record
time/date of sample receipt
and when plasma
removed.
HCV Genotype +/- Load
Parvovirus B19 PCR
Polyomavirus (BK) PCR
HHV6/7/8
Enterovirus RT-PCR
Adenovirus PCR
MTHFR
HNPP
SCA 1-7
Jak2 Mutation
BCR-ABL
Cystic Fibrosis Genetic
Testing
BRCA1/2
Adenovirus PCR
Norovirus PCR
FAP Genetic Testing
QS-Proc-5
Specimen Requirement
ACD or EDTA Blood
(remove plasma)
Serum
EDTA Blood
ACD or EDTA Blood
(plasma removed from
same)
Refer EDTA Plasma-Send
Frozen
Author : Dr Tom Hartley
Testing Laboratory
VIDRL
VIDRL
VIDRL
Clinical Research
Laboratory, Macfarlane
Burnet Centre for Medical
Research
Serum
Whole Blood
CSF/Blood/Urine
CSF/Blood
CSF/Blood
Various
EDTA Blood
EDTA Blood
EDTA Blood
EDTA Blood
EDTA Blood (x2)
EDTA Blood
VIDRL
VIDRL
VIDRL
VIDRL
VIDRL
VIDRL
Royal Melbourne
VCGS
VCGS
Royal Melbourne
IMVS
VCGS
EDTA Blood (x2)
Various
Faeces
EDTA Blood
Peter MacCallum
VIDRL
IMVS
VCGS
Authorised by Drs Marsden & Vervaart
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Results and Enquiries
All results are available via the DMR once authorised.
Retention times
All samples are retained according to NPAAC requirements. Currently this requires the laboratory to
retain material processed for genetic testing indefinitely. Sample for routine infectious disease
studies are retained at least until the final result is authorised.
Retrospective requesting (Add on tests)
Add on tests can be made for samples that have been collected for Molecular studies only. Add on
requests for samples that have been collected for and used by other areas of pathology are
unacceptable.
_________________________________________________________________________________
ENDOCRINOLOGY
The Endocrinology Laboratory functions as a tertiary referral centre for the investigation of most
endocrine disorders. The service includes :
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A comprehensive range of basic and specialised hormone assays that are indicated in
the areas of Diabetes, Thyroid, Adrenal, Pituitary, Fertility, Growth and Parathyroid
disorders.
Tests carried out in the dynamic assessments of patients to investigate abnormalities
in trophic to target hormone relationships.
Biochemical and genetic screening of patients who have Multiple Endocrine
Neoplasia Type 1, (MEN1).
The Department has strong research commitments in the areas of Thyroid
Autoimmunity and metabolism, Diabetes management, MEN1 and other inherited
endocrine malignancies, Parathyroid and Calcium metabolism. Both the Laboratory
and the RHH Endocrinology Department have significant external funding to support
these programmes and have gained significant recognition both nationally and
internationally for their research work.
The staff contribute significantly to the undergraduate and postgraduate teaching programmes of the
RHH and the University of Tasmania.
Laboratory Opening Hours
0900 – 1730 Monday to Friday (excluding public holidays)
Tests performed Daily
QS-Proc-5
TSH, FT4, FT3
LH, FSH
Progesterone, Estradiol
Prolactin,
Growth Hormone
Cortisol.
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Authorised by Drs Marsden & Vervaart
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Tests performed weekly or twice weekly
PTH
Vitamin D
ACTH
Anti-TPO,
Thyroglobulin/Anti-thyroglobulin,
C-Peptide, Insulin,
IGF1
DHEA-SO4, Testosterone/SHBG
Chromogranin A
Tests performed approximately every 2 or 3 weeks
Gastrin,
17OH-Progesterone
Aldosterone, Plasma Renin Activity
Alpha Sub-unit
Urine Corticoids
GAD-Ab, IA2-Ab & Thyroid Receptor Ab
Tests performed approximately 6 – 8 weeks
11 Deoxycortisol
Glucagon
Pancreatic Polypeptide & Vasoactive Polypeptide
Referred Samples/Referred Tests
Tests sent to other laboratories include :
Calcitonin
TBG
Total T4
Sulphoylurea Screening
7 Dehydrocholesterol
IGFBP3
Plasma Metanephrines
11 Deoxycorticosterone
Urinary Deoxypyridinoline
c-AMP
Neurotensin
Reverse T3
Urinary Iodine
Adrenal Abs
Plasma Catecholamines
IGF2
ADH
Urinary Steroid Screen
1,25 Vit D
Insulin Abs
Ovarian Abs
Osteocalcin
Androstenedione
Genetic Screening for: MEN 2, 1oHyperaldosteronism, VHL, SDHB, Neurofibromatosis
MEN1 gene for non-Tasman 1 families.
Others by prior arrangement.
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Special investigations/protocols
The following special investigations are performed by the Endocrinology Department. Please call
the Lab for instructions/protocol on Extn 8781
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Addisons disease
Cushings syndrome
Hypothalamic pituitary adrenal axis
Growth Hormone deficiency, Acromagaly
Congenital Adrenal Hyperplasia,
Hypoglycemia, Diabetes
Medullary thyroid carcinoma investigations
Pseudo hypoparathyroidism
Diabetes Insipidus
Pituitary function test
Prolactin and prolactinomas
Thyroid hormone absorption test
Primary hyperaldosteronism
A range of special investigations details and protocols are available on request from the endocrine
laboratory Ph 6222 8781
Cut-off Times for Sample Processing and Referral
Samples for daily assays should reach the laboratory prior to 1530 for processing so results are
available the same day. Otherwise next working day turnaround should be expected.
Samples for referral to mainland laboratories should reach the laboratory before 12 noon so that they
are ready for a 14:00h pick-up on Mondays through to Thursdays.
Storage conditions for samples
Samples received for hormone testing have to be processed as soon as possible and stored at 4o or
minus 20o C as appropriate
Telephoning Results
Results will be telephoned on special request. Results will normally be provided to medical staff
only
Turnaround times
Routine tests are done everyday whilst low volume test requests are done once a week or once every
two weeks depending on the number of requests
Emergency On-Call
Contact the RHH switchboard for Endocrinology on-call personnel
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Authorised by Drs Marsden & Vervaart
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Laboratory Notification of Emergency Samples during Routine Hours
Normally endocrine test requests are not done on an urgent basis as most management decisions will
not be affected if the test is performed on the next scheduled assay run. If, however, an earlier result
is required, the medical officer is to telephone the laboratory (8781) and request that the test(s) be
performed urgently. Such requests will be noted and the tests done as soon as possible and the
results(s) telephoned when available.
Laboratory Notification of Emergency Work Outside of Routine hours
Contact the RHH switchboard and discuss your request with the on-call endocrinologist, they will
call in an appropriate staff member if required.
Tests available outside of routine hours
Tests which may be indicated urgently out of hours:


TSH, FT4 & FT3 in the case of acute thyroid disease
Cortisol in acute adrenal disease
Point of Care Testing (POCT)
POCT in the Endocrine Unit is administered through Specialist Clinic & Diabetic Education and is
overseen by Clinical Chemistry
Reference Values
A full list of reference values is available in the Endocrinology Lab Handbook. Reports are issued
with the reference interval appropriate for the patient’s gender, age and clinical condition.
Repeat Samples
Abnormal results are assessed and reanalysed if required and the result confirmed. The requesting
doctor (or if unavailable the Duty Endocrinologist) is notified when immediate medical action is
needed. A repeat sample or additional testing may be indicated to confirm the initial abnormal
result. Duplicated requests in other situations may not me analysed.
Reporting of Results and Result Enquiries
Final results are released into the Kestral Laboratory Information System after verification by an
Endocrinologist who will make comments if required. Samples are kept approximately 7 – 10 days
post analysis. If additional tests are to be added contact the Endocrine Laboratory (03) 6222-8781
and also send or fax (03) 6222-7537 an add-on form specifying the additional tests required. Tests
will be added depending on sufficient serum being available.
Retention times
Samples are retained by the Endocrine Lab for a maximum time of 2 months.
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Authorised by Drs Marsden & Vervaart
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Retrospective requesting (Add on tests)
Add on tests will be accepted wherever possible provided enough sample is available for doing the
tests requested. An add on form signed by the requesting Dr is mandatory for the tests to be
performed
_________________________________________________________________________________
SPECIAL INVESTIGATIONS
This includes the Specialised Haematology, Stem Cell Transplant Service, the Flow Cytometry
Laboratory and the Specialised Chemistry Laboratory.
This is the major Tasmanian Referral Laboratory for haematology investigations requiring specific
expertise and receives specimens from all public and private sector pathology services in Tasmania.
The laboratory is divided into four functionally distinct areas.
The Stem Cell Transplant Laboratory provides all aspects of the statewide Bone Marrow Transplant
Service, as well as expert advice and resources to clinicians. This laboratory receives harvested bone
marrow or peripheral blood, processes, tests and cryopreserves the stem cells and maintains the bone
marrow cryogenic facilities.
The Flow Cytometry Laboratory provides a Statewide Cell Marker service performing the following
investigations :

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Immunophenotyping of lymphoproliferative and myeloproliferative disorders to assist
in diagnosis and classification.
Measurement of lymphocyte subsets as part of the assessment of immune status in
HIV/AIDS and other suspected immune deficiency states
Quantitative CD34 assays to evaluate the transplantation of potential stem cell
harvests.
The Special Haematology Laboratory performs specialist testing including :
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Haem pigment investigations
Red Blood Cell haemolysis investigations
Identification of Malarial Parasites
ELISA based assays including Anticardiolipin, glycoprotein, Intrinsic Factor
antibodies
The Specialised Chemistry Laboratory performs a range of specialised, complex and largely nonautomated tests for clients throughout Tasmania including organizations requiring occupational
monitoring. Specialist testing includes


Trace element analyses : Lead and cadmium, usually for occupational monitoring and
copper and zinc, usually for nutritional studies and parenteral nutrition patients
A large number of qualitative and quantitative protein assays by


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Automated immunoassays
Electrophoresis
Author : Dr Tom Hartley
Authorised by Drs Marsden & Vervaart
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
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and isoelectric focussing
Faecal occult blood
Antinuclear antibodies
urinary free catecholamine analyses using high performance liquid
chromatography, (HPLC), for the diagnosis of phaeochromocytoma as well as
neuroblastoma and similar diseases in children.
Autoimmune Testing Service
The Specialised Investigations Unit provides an autoimmune testing service incorporating ANA,
ENA, ANCA, and also coeliac screening. This service is under continuous development.
Laboratory Hours
The laboratory is routinely open Monday to Friday 0800 to 17:00, excluding public holidays.
On-Call Service
All requests for after-hours service must be made to the Haematologist on-call via the Royal Hobart
Hospital switchboard on 03 6222 8308.
Collection of Samples
As per on-line Test Information Database. Specific queries may be directed
to the laboratory
Notification of Results
Authorised results on Hospital patients are available on the Royal Hobart Hospital DMR system. If a
result does not appear on the hospital DMR system please call Special Investigations laboratory on
6222 8774. Results for non RHH hospital patient will be reported in hard copy and, by request,
electronically to the GP’s patient management system
Urgent Samples
Please inform the laboratory if results are required urgently. This may need to be negotiated with a
Haematologist in some cases (on-call if after-hours).
_________________________________________________________________________________
ANATOMICAL PATHOLOGY DEPARTMENT
This includes Routine Histology, Immunohistology, Cytology, Electron Microscopy, and the
Mortuary.
This Department is the major public sector specialist referral centre for Anatomical Pathology in
Tasmania and provides
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QS-Proc-5
a surgical biopsy service
an autopsy service
gynaecological and non-gynaecological cytology services, including fine needle
aspirate cytology
a statewide renal biopsy service
a State Reference Service for specialist techniques such as electron microscopy and
immunohistochemistry.
Author : Dr Tom Hartley
Authorised by Drs Marsden & Vervaart
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
For muscle biopsies and nerve biopsies please contact the histology department at
least 24 hours before the procedure on 6222 8298 (ext 8298) to arrange delivery of
the required kits.
Renal biopsies – place sample in an appropriately labelled empty container and
deliver to the laboratory immediately for determination of adequacy.
For breast tissue requiring x-ray – place sample in an appropriately labelled empty
container and immediately notify the histology department on 6222 8298 (ext 8298).
Duodenal biopsies for disaccharidase – obtain liquid nitrogen from the histology
department before the procedure. Once the sample is frozen deliver the frozen tissue
immediately to the histology department.
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The Department also has a considerable involvement with undergraduate teaching in anatomical
pathology and has trained the majority of specialist anatomical pathologists practising in Tasmania.
HISTOPATHOLOGY
Laboratory Hours
The histology laboratory is open Monday to Friday 08:30 to 17:00.
On Call Service
To contact the on-call Anatomical Pathologist outside the laboratory opening hours please call the
Royal Hobart Hospital switchboard on 03 6222 8308.
To contact the on-call scientist outside the laboratory opening hours please call 0417 312 460.
Tests
The histology department provides a comprehensive histology service including:
 histopathology
 immunohistochemistry
 immunofluorence
 frozen section
 electron microscopy
Collection of Samples
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Samples for frozen section – place sample in an appropriately labelled empty container
and immediately send fresh sample to the laboratory;
Samples for immunofluorence – place sample in an appropriately labelled empty
container and immediately send fresh sample to the laboratory;
Samples for electron microscopy – place sample in an appropriately labelled empty
container and immediately send fresh sample to the laboratory.
Samples for routine histology ONLY should be placed into 10% Formalin (available
from the histology department) as soon as possible after being removed from the patient
and forwarded to the histology department.
If in any doubt on how to collect samples please contact the histology laboratory on 6222 8298 (ext.
8298).
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Notification of Results
Authorised results are available on the Royal Hobart Hospital DMR system. If a result does not
appear on the hospital DMR system please call the Anatomical Pathology office on 6222 8770 (ext
8770) to discuss results with an Anatomical Pathologist.
Urgent Samples
If a sample result is required urgently please call the Anatomical Pathology office on 6222 8770
(ext. 8770) to discuss requirements with an Anatomical Pathologist.
CYTOLOGY
Laboratory Hours
The cytology laboratory is open Monday to Friday 08:30 to 17:00.
On Call Service
To contact the on-call Anatomical Pathologist outside the laboratory opening hours please call the
Royal Hobart Hospital switchboard on 03 6222 8308.
Tests
The Cytology Department provides a comprehensive cytology service including:

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
gynaecological cytology (Cervical Screening Program)
non-gynaecological diagnostic cytology
fine needle aspiration cytology
Collection of Samples
Gynaecological Cytology (Pap Smears)


Conventional smear labelled with patient`s Surname, Given Name and Date of Birth must
be inserted immediately into 95% ethanol
ThinPrep specimen should be made after making conventional Pap smear rinsing Cervex
sampler well in the ThinPrep solution
Non-Gynaecological Cytology


All fresh specimens for cytology should be sent to the Cytology Department without delay
Samples collected into CytoLyt Preservative Solution should be kept at room temperature
and forwarded to the cytology department
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Authorised by Drs Marsden & Vervaart
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Fine Needle Aspiration Cytology
The Cytology Department within the RHH Department of Anatomical Pathology offers both an
inpatient and outpatient fine needle aspiration service.
Lesions suitable for free hand fine needle aspiration should be readily palpable lumps of at least 1cm
in size. Examples of suitable lesions include lymph nodes and superficial breast lesions.
The aspiration will be performed either by one of the staff Specialist Anatomical Pathologists or an
appropriately trained Anatomical Pathology Registrar.
All referrals for either free hand or image guided fine needle aspiration should be pre-booked by
ringing the Cytology Department on 6222 8235 (ext 8235).
If in any doubt on how to collect samples please contact the Cytology Laboratory on 6222 8235 (ext.
8235).
Notification of Results
Authorised results on Hospital patients are available on the Royal Hobart Hospital DMR system. If a
result does not appear on the hospital DMR system please call the Cytology Department on 6222
8235 (ext 8235). Results for non RHH hospital patient will be reported in hard copy and, by request,
electronically to the GP’s patient management system
Urgent Samples
If a sample result is required urgently please call the Anatomical Pathology office on 6222 8770
(ext. 8770) to discuss requirements with an Anatomical Pathologist.
Mortuary
All enquires relating to autopsies requests and reports should be forwarded to an Anatomical
Pathologist Monday – Friday, 08:30 – 17:00 on 6222 8770 (ext. 8770).
All other mortuary enquires should be forwarded to the Senior Mortuary Technician on 6222 8336
or 6222 8333 (ext. 8336 or 8333).
_________________________________________________________________________________
SUPPORT FOR RESEARCH : SAMPLES AND PROTOCOLS
Pathology Services at the Royal Hobart Hospital are committed to Clinical Research. We are able to
support other Units in the DHHS with their requirements for pathology data in their Research and
Development Projects. DHHS staff are encouraged to come to Pathology Services as early as
possible in their project planning stage. At that time we can discuss the optimum way of meeting
your requirements, set up internal project codes within our IT system, so that your data can be easily
extracted at anytime during the project, and organise the financial implications of the anticipated
workload.
Research work for non DHHS staff and drug trials can also be accommodated the only differences
being that we will need to discuss more fully the issues of legal liabilities and costs.
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Please contact Dr Peter Vervaart on 6222-8240 to begin the process of collaboration.
PROCEDURE
• Investigators are encouraged to seek laboratory input from the Laboratory Director and/or
Scientist in Charge during study design to ensure the most appropriate tests, methods and
specimens are used.
• Discussions should be undertaken with the senior scientist and medical director in the
relevant functional unit(s) who will decide whether it is feasible to perform the requested
work in their area. However, no undertaking for involvement of Pathology Services can be
given until the costing and resource requirements have been approved by the Principal
Scientist.
The protocol will be examined in terms of:
a. tests required,
b. number of subjects,
c. number of samples,
d. special collection parameters,
e. storage requirements,
f. frequency of testing,
g. sample treatment/preparation by laboratory staff,
h. development of methods,
i. impact of workload on department staff and budget,
j. starting date and
k. study duration.
• If the senior scientist decides it is feasible for their area to be involved, the Investigator or
Study Coordinator will be requested to complete the Research Trial/Study Information
Proforma and return it to the Principal Scientist, Dr Peter Vervaart along with a copy of the
relevant sections of the research protocol.
• The Pathology Services Research Trial/Study Information Proforma can be obtained from
Peter Vervaart.
Please Note: If there are tests to be incorporated in the study that would normally be
performed as part of patient investigation or treatment, they will need to be clearly
identified on the proforma. To enable Pathology Services to invoice Medicare, these
tests will also need to be requested on a separate request form to tests that are only
required for the study.
• Once the Proforma has been approved by the Principal Scientist, an internal RHH Study
Code will be assigned to each project to facilitate management
• Cost of (a) specimen collection (if required), (b) testing, transport and (c) storage (if
required), based on the cost of these to Pathology Services will be determined, and a written
agreement, along with the internal RHH Study Code will be forwarded to the Principal
Investigator and the Study Coordinator.
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• Please quote this RHH Study Code at subsequent enquiries and also display it on Pathology
Request Forms accompanying research project specimens.
• The above process should occur prior to Investigators seeking Ethics Committee approval
so that Pathology Services is able to “sign off” on the protocol. However, Pathology Services
involvement in any study will not be able to commence until the study has been approved by
the Institutional Ethics Committee. Copy of the Ethics Approval form should be forwarded to
the Principal Scientist before the study commences.
• The Principal Scientist must be formally notified of the completion of any study involving
Pathology Services so that documentation can be completed.
• Appropriate recognition of the input from Pathology Services (and/or its staff members) is
required. This may range from acknowledgment in publication to co-authorship as
appropriate to the level of participation.
GUIDE TO THE ORGANISATIONAL STRUCTURE OF RHH PATHOLOGY SERVICES
Director of Pathology
Services
Quality Manager
Business Manager
Principal Scientist
Pathologist Directors of
Departmental Laboratories
 Anatomical Pathology
 Core Laboratory
 Cytogenetics
 Endocrinology
 Microbiology
 Molecular Medicine
 Special Investigations
Scientists in Charge of
Departmental Laboratories
 Anatomical Pathology
 Core Laboratory
 Cytogenetics
 Endocrinology
 Microbiology
 Molecular Medicine
 Special Investigations
PATHOLOGY SERVICES STAFF PHONE NUMBERS
Senior Management
Director of Pathology Dr Katherine Marsden 6222 8410
Principal Scientist Dr Peter Vervaart 6222 8240
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Business Manager Mr Mike Jones 6222 8948
Pathologists
Anatomical Pathology
Dr David Challis (Director) 6222-8770
Dr Peter Jessup
Dr Helene Rees
Dr Eileen Long
Dr Shaun Donovan
Dr John McArdle
Clinical Chemistry
Dr Udayan Ray (Director) 6222-8234
Endocrinology
Dr John Burgess (Director) 6222-8732
Dr Tim Greenaway
Haematology
Dr Katherine Marsden (Director) 6222-8337
Dr James Daly
Dr Liz Tegg
Dr Roger Kimber
Microbiology
Dr Maree O’Sullivan, (Director) 6233-3557
Dr Louise Cooley 6222-8255
Dr Alistair McGregor
Dr Tara Anderson (Infection Control)
Dr Alison Ratcliffe
Sexual Health Service
Statewide Director : 6233-3557
Senior Staff
Anatomical Pathology
Mr Alistair Townsend (Sci. in Charge) 6222-8771
Deanne Lamb (Cytology) 6222-8235
Nino Mele (Mortuary)
Core Laboratory
Mr Rob White (Sci. in Charge) 6222-8199
Ms Terri Kidd (Haematology) 6222-8776
Mr Michael Robinson (Coagulation) 6222-8776
Mr Michael Smillie (Biochemistry) 6222-8775
Ms Gina Aitken (Transfusion) 6222-8411
Central Specimen Reception
Brett Clem : Preanalytical Manager : 6222-8775
Ms Kathy Barry : 6222-8657
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Centrepath
Reception Desk 6214-3058 or 6222-7121
Jane Stevenson (Business Development Officer) 0419 137 121
Heather Rainbird (Senior Phlebotomist)
Cytogenetics
Ms Karen Dun (Sci. in Charge) 6222-8297
Endocrinology
Dr V (Paramesh) Parameswaran (Sci. in Charge) 6222-7991
IT Support—Pathology Results Lookup System only )
Mr Andrew Hudspeth 6222-8396
Mr Graham Banks (IT Technician) 6222-8941
Microbiology
Mr David Jones (Sci. in Charge) 6222-8909
Viral Serology 6222-8777
Molecular Medicine
Dr Jan Williamson (Sci. in Charge) 6222-8912
Phlebotomy Service
Mrs Claire Beattie 6222-7955
Purchasing Officer : Philip Bakes : 6222-8347
Quality Systems
Dr Tom Hartley (Quality Manager) 6222-8780
Special Investigations
Mr Andrew Hudspeth (Sci. in Charge) 6222-8396
Dr Scott Ragg (Flow Cytometry and Stem Cell Transplantation) 6222-8431
Ms Janet Bartle 6222-8742(Special Chemistry)
PATHOLOGY SERVICES DEPARTMENTAL FAX NUMBERS
Pathology Administration : 6222-8996
Central Processing Unit : 6222-7537
Centrepath : 6222-7097
Pathology Stores : 6222-8047
QUALITY SYSTEMS
The overall coordination and management of the quality systems in this Department are the
responsibility of the Quality Manager under the supervision of the Director of Pathology and the
Principal Scientist. The departmental Directors and Scientists in Charge are the line managers with
the responsibility for ensuring that these systems are practiced in their areas of responsibility.
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The Quality Manager is assisted by a Quality Technician.
One of the major cornerstones of our Quality Systems is the Document Control system. All
documentation that relates directly to Medical Testing or our Quality Systems is registered within
the Document Control System. The purpose of a Document Control System is to ensure that we
retain all documentation relevant to medical testing in an orderly and easily retrievable form both for
the purposes of keeping staff advised of the documentation required in their work and also to enable
us to retrieve documentation relevant to auditing all possible factors in an adverse event.
A second major cornerstone is the Corrective Action / Preventative Action system within which we
lodge all incidents that relate to adverse events during the Preanalytical, Analytical or Reporting
phases of Medical Testing.
LABORATORY ACCREDITATION
This laboratory is a NATA Accredited Medical Testing Laboratory that meets all the requirements
of ISO 151819, ‘Medical Laboratories – Particular Requirements for Quality and Competence.’
We also hold appropriate accreditation from the TGA and the Office of the Gene Technology
Regulator.
NATA Accreditated Laboartory Number = 3036
Medicare Accreditation Nunmber =38273
EXTERNAL QUALITY ASSURANCE PROGRAMMES
The laboratories are enrolled in the following External Quality Assurance Programmes
Royal College of Pathologists of Australia
Anatomical Pathology
General Diagnostic Module
Breast Diagnostic Module
Oral Diagnostic Module
Dermatopathology Diagnostic Module
Forensic Diagnostic Module
Gynaecological Diagnostic Module
Paediatric Diagnostic Module
Urological Diagnostic Module
Technical Module
Transmission Electron Microscopy
Immunohistochemistry Modules
Immunohistochemistry Diagnostic Module
Immunohistochemistry Technical Module
Immunohistochemistry Breast Markers Module
Immunohistochemistry Lymphoma Markers Module
Her2 Brish
Biochemistry:
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Alcohol / Ammonia
Blood Gases & CO-oximetry
BNP
CSF
Endocrine
General Serum Chemistry
Glycohaemoglobin
IGF-1 / C-Peptide
Neonatal Bilirubin
Special Drugs
Special Lipids
Sweat Electrolytes
Tumour Markers
Urine Chemistry & Biogenic Amines
Urine Pregnancy Testing
Urine Toxicology
Vitamins (B12 and Folate )
Cytology:
Gynaecological Modules
General Cytopathology Module
Liquid Based Gynaecological Module
FNA Module
Cytology Performance Measures Module
Haematology :
FBC
Haemostasis
D-Dimer
Morphology/Differentia
Automated Differential
Point of Care - INR
Oncology Immunophenotyping
Specialised Haemostasis
CD34+
G6PD
Immunology :
Antinuclear Antibodies
Rheumatic Disease Serology
Vasculitis Serology
Coeliac Serology
Tissue Antibodies
Juvenile Onset Type I Diabetes Antibodies
C-Reactive Protein
Specific Proteins
Rheumatoid Factor
Paraproteins
Immunophenotyping
Microbiology :
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Bacteriology
Mycology
Parasitology
Synovial Fluid
Legionella Urinary Antigen
Serology:
Cytomegalovirus
Epstein Barr Virus
Helicobacter pylori
Hepatitis A
Hepatitis B
Hepatitis C
HIV
Infectious Mononucleosis
Rubella IgG / Total
Syphilis
Toxoplasma
Varicella zoster virus
Transfusion Medicine :
General Compatibility Module
Phenotyping Module
Antibody Titre Module
Foeto Maternal Haemorrhage Program
Molecular Medicine :
 RCPA QAP in Haematology (Molecular Diagnostics)
 Factor V Leiden
 Prothrombin gene mutation
 Haemochromatosis
 T and B cell gene rearrangements
 RCPA Serology
 HPV (from 2008)
 HCV
 Avian Influenza
 Pandemic Influenza
 RCPA Microbiology (NAT)
 Bordetella pertussis
 Chlamydia trachomatis
 CMV
 Enterovirus
 HSV
 mecA
 Neisseria meningitidis (from 2006)
 Mycobacterium tuberculosis (from 2008)
 VZV (from 2009)
 National serology reference laboratory
 HCV
 HSV
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

CMV
Chlamydia trachomatis
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Acknowledgements
The author acknowledges the authors of the Naas General Hospital, Co. Kildare, Ireland, for www
access to their Primary Sample Collection Manual. This manual has followed their lead in the logical
organisation much of the content.
http://www.hse.ie/eng/services/Find_a_Service/HospsCancer/Naas/Pathology.pdf
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