General Expectations of the Laboratory
All requests for work must be made electronically using the Clinisys ICE Ordercomms system.
In the event of an ICE system failure, the reverse side of the ICE stationary should be completed manually and legibly until the system is restored.
It is essential that request forms are always completed in full with the information required:
The patient’s full name and date of birth
The patient’s unit number
The requesting location
The name of the consultant or GP
Patient’s NHS number (GP patients)
Patient’s address (GP patients)
Brief but relevant clinical details
The requesting doctor’s name (printed) and bleep / telephone number
The date and time of the sample
Failure to provide this information may lead to samples not being tested or delays in results being returned.
Electronic ordering will provide most of this information automatically. Brief clinical details, however, need to be entered.
The request form must be accompanied by the correct sample which should be transported to the laboratory sealed within in the special specimen bag attached to the request form.
‘High Risk’ Samples
Samples from patients with blood borne virus diseases constitute a particular hazard to laboratory staff. All infectious specimens and their accompanying request forms should be clearly marked with ‘Danger of Infection’ stickers.
The range of investigations available on such specimens may be limited. Please contact the laboratory for further information.
Where samples are collected at home by the patient (e.g. 24 hour urine collections and Post-vasectomy semen analysis), the information for the collection procedure and the sample container will be provided by the requesting clinical area.
Appropriateness of the Request
Biochemical requests are only of clinical significance when ordered in the correct context and within an appropriate time frame. Where possible, ICE will prompt the user that existing requests or results already exist on certain analytes to prevent over-ordering of the same tests, therefore, reducing analysis costs and ensuring the best care for the patient.
Doctors requesting investigations should bear in mind Asher’s catechism (British Medical Journal 1954; ii: 460).
- Why do I request this test?
- What will I look for in the result?
- If I find what I’m looking for will it affect my diagnosis?
- How will this investigation affect my management of this patient?
- Will this investigation ultimately benefit this patient?
Uncertainty of Laboratory Results
All pathology assays carry an inevitable degree of uncertainty. Whilst many factors are well recognized (pre-analytical variables, analytical precision) some occur by random error alone.
(A random error is associated with the fact that when a measurement is repeated it will generally provide a measured value that is different from the previous value. It is random in that the next measured value cannot be predicted exactly from previous such values).
Users should bear in mind these uncertainties when interpreting any laboratory value.
Please refer to document: Measurement of uncertainty in Blood Sciences
The laboratory is happy to discuss analytical variation with any user of the service.
Laboratory EQAS performance data is available to any interested user – please contact the laboratory.