Infection Control
Specimen Collection, Handling
and Transport Guidance
To be read in association with:
Communicable Diseases Policy
Environmental Policy & Objectives
COSHH Policy
Infection Control Guidance and Procedures
Review date: Dec 2011
Nov09/ver01
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Contents
1. Purpose
page 3
2. Scope
page 3
3. Background
page 3
4. Specimen collection, handling & transporting page 4
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4.1 Specimen transport
4.2 Collection of specimens
4.3 Labelling
4.4 High risk ‘Biohazard’ specimens
4.5 Storage of specimens
4.6 Leaking specimens
4.7 Designated collection points
page 4
page 4
page 5
page 5
page 6
page 6
page 6
5. Staff Training
page 6
6. References
page 7
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1, Purpose
The purpose of this guidance is to set out the standard for the collection,
handling and transport of clinical specimens by staff of Nugent Care. Nugent
Care is committed to the welfare, health and safety of their staff, patients and
visitors. As such they will ensure, so far as is reasonably practicable, that all
employees, patients and visitors to their respective sites are protected from
potential biological hazards or emotional stress, that may arise from the
collection, dispatch, transportation and receipt of any biological materials.
This guidance excludes specimen handling procedures used by external
laboratory staff these are subject to separate protocol. It remains the prime
responsibility of the sender to package specimens according to the relevant
legislation in force.
2, Scope
Specimens are transported under the assumption that all are potentially
infectious. This guidance will apply to all staff working within Nugent Care who
are involved with the collection, handling and transport of clinical specimens.
3, Background
A specimen is a body substance, such as blood, sputum, pus, urine or faeces,
taken from a person for the purpose of analysis. The aim of such analysis is to
identify micro-organisms that cause disease and to provide direction for
appropriate treatment.
Specimens, if not handled and transported safely, can pose a risk of infection to
all people involved, including care workers, patients and their volunteer carers,
receptionists, office workers and transport personnel.
Any accidental spillage must be cleaned up by staff using personal protective
equipment (PPE) provided to prevent potential contamination.
All staff managing clinical specimens should be offered the appropriate
Occupational Health advice and seek inoculation from their GP’s, where
required.
Accurate analysis is crucial in determining the correct diagnosis, or detecting an
infectious agent, so that appropriate and timely treatment can be commenced. To
support this, factors such as the correct collection technique, storage conditions,
and interval before reaching the laboratory, the collation of supporting information
and the supplying of correct service user details should be observed.
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In the community, specimens are collected in a wide variety of settings including
the patient’s home, but also samples are taken in Nugent Care residential
settings and this policy should be applied to both service types.
4, Specimen collection, handling and transportation.
4.1 Specimen transport containers
Specimen transport containers should always be used and these must be
sufficiently robust to withstand reasonable stresses likely to be put upon them
during transportation to the point of collection. The containers should be
insulated to avoid extremes of heat or cold and also be a secure rigid, robust and
leak proof container with a handle and a tight fitting lid These boxes must not be
used for any other purpose than carrying Pathology specimens, and must be
labeled accordingly.
All staff must be aware of what to do in the event of spillage and refer to the
appropriate procedure and policy(s). Containers for transporting specimens
should be cleaned daily to reduce the risk of transmission of micro organisms
and this should be done by using hot water and detergent (or detergent wipe if
available), and then rinsed and dried. Should the container become
contaminated with blood or body fluid it must be decontaminated. Refer to the
procedure / risk assessment or safe system of work to undertake this task in
safety.
Specimens to be transported to the GP Practice or hospital site from a home
must be bagged or contained in a way which is appropriate for the type of
specimen, following the guidance / instruction supplied with this appropriate
packaging type and then placed in a designated specimen transport container.
4.2 Collection of specimens
Always follow infection control precautions when handling specimens e.g.
ensure appropriate protective clothing (PPE) is used and waste, including sharps
waste is disposed of safely and correctly.
Write details on container immediately after taking the specimen, DO NOT take
away and label prior to filling. Details should include patient’s name, and date of
birth, type of specimen. The specimen should then be placed directly into the
clear bag and then into the specimen transport container.
Ensure positive identification is displayed on the container / swab.
Ensure correct specimen container / swab is used.
Whenever possible always take specimen prior to commencing antibiotics.
Where appropriate, obtain all specimens with sterile equipment and place in
sterile containers, ensuring that the outside of these containers are always free
from contamination with bodily fluids (stool and sputum specimens are not sterile
specimens).
Collect fresh specimen material which is as free from extraneous contamination
as possible, take material only from the site of infection.
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Prior to taking swabs from a dry area; i.e. nasal screening, the tip should be
moistened in sterile normal saline.
Do not overfill containers especially faecal containers. These can ‘explode’ on
opening.
Any container containing a specimen that will be sent to a GP for analysis must
be robust and not leak during normal use and be suitable for its purpose. Any
failings of the integrity of these containers must be monitored and an incident
form should be completed, where failure occurs.
Secure the lids of containers immediately after their use, in order to avoid
spillage and contamination during transportation.
Store specimens in a cool place - some samples may require refrigeration (see
4.5 ‘Storage of Specimens’ below).
Do not allow the outside of the container to become contaminated. .
Enter individual details on both the container and the request form.
Place the container into the accompanying specimen plastic bag, with one
compartment containing the request form and the other containing the specimen.
Wash hands after specimen handling and glove removal.
4.3 Labelling
Every specimen container and request form must describe the nature of the
specimen and its source, full resident or service user information allows the
receiving laboratory staff to identify the source quickly in the event of the
specimen and form becoming separated.
All specimens must be placed in a specimen bag with the request form in the
separate pocket of the bag.
An additional 'Danger of Infection' label must be attached to specimens and
request forms for known or suspected “high risk” pathogens. If staff do not have
access to such labels then the form and specimen must be clearly identified as
‘high risk’ (staff may wish to write in red or use a highlighter pen).
4.4 High risk “Biohazard” specimens
Specimens containing or suspected of containing high risk micro-organisms
require handling and processing differently in the receiving laboratory in order to
protect laboratory staff and to reduce the risk of cross infection. All such
specimens and the request forms must have an appropriate biohazard sticker
attached. Various stickers are available but they must be yellow in colour and
state “biohazard”.
High-risk micro-organisms include:
Human Immuno-Deficiency Virus (HIV) Viral haemorrhagic fevers
Hepatitis B Virus (HBV) Rabies
Hepatitis C Virus (HCV) Anthrax etc
Tuberculosis (TB) Prions
Hepititis E E-Coli 0157
Salmonella Typhimurium etc.
NB: Swabs for MRSA carriage are not high risk.
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4.5 Storage of specimens
Any fridge that is used for the storage of specimens MUST NOT be used for the
storage of any food items or drugs, including vaccines.
The fridge should have a minimum / maximum thermometer and be regularly
cleaned and serviced as directed in the cleaning schedule, inline with recognised
frequency standards
Sputum should be sent to the laboratory as soon as possible on the daily
specimen pick up. Respiratory pathogens will not survive for prolonged periods.
Do not leave specimens, including Sputum, over the weekend or bank holidays.
4.6 Leaking specimens
Where specimen containers are leaking into sealed transport bags, the bag and
its contents should be discarded as clinical waste and collection of a new
specimen should take place. If the specimen is unrepeatable, it should be
carefully transported to the laboratory - the laboratory will have its own policies
and procedures for dealing with the occurrence of these circumstances.
4.7 Designated collection point
All specimens are to be taken to the designated secure collection area identified
within the workplace until they are ready for collection or transport.
5, Staff Training
All staff must receive training in infection control as part of their induction
program and as per Nugent Care’s training matrix. Infection Control information
will also be delivered in house, as regular updates during meetings and talks etc.
Infection Control should be discussed at staff appraisals and objectives set within
Personal Development plans. All staff with responsibility for Specimen collection,
handling and transport must be adequately trained and made aware of the
importance of following this Nugent Care policy, this is essential for both to meet
the standards required and to achieve staff safety. Regular on-the-job training is
provided to ensure all staff are aware of current practices and procedures.
Training should include:
Induction
Update training annually
Infection Control
Correct Cleaning Methods
Standards required
COSHH regulations
Personal Protective Equipment
Decontamination techniques
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6, References and further information
Carriage of Dangerous Goods (Classification, Packaging and Labelling)
Regulations
Use of Transportable Pressure Equipment Regulations
Legislation
Health and Safety at Work etc Act 1974
Control of Substances Hazardous to Health Regulations
The Management of Health and Safety at Work Regulations
The Reporting of Injuries, Diseases and Dangerous Occurrences
Regulations
The Carriage of Dangerous Substances by Road and Rail (Classification
Packaging and Labelling) Regulations
The Genetically Modified Organisms (contained use) Regulations
The Health and Safety (Dangerous Pathogens) Regulations
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