Basingstoke and North Hampshire NHS Foundation Trust Revision: 7 Q-Pulse Filename: MP-GEN-HANDBK
Basingstoke & North Hampshire Hospital
Author: David Beacher Authorised by: N. Hutchinson
PATHOLOGY DIRECTORATE Date of issue: 23 June 2011 Page 64 of 64
BASINGSTOKE AND NORTH HAMPSHIRE HOSPITAL
PATHOLOGY USER HANDBOOK
Author : Pathology Collaboration
: Co-ordinator: David Beacher
Authorised By : Dr. N. HUTCHINSON (Clinical Director)
Date of Next Revision : June 2012
DO NOT USE AFTER : July 2012
This document replaces revision 6 issued December 2010
PREFACE 3
INTRODUCTION 4
PATHOLOGY MANAGEMENT 5
General Pathology 5
Blood Sciences 5
Histopathology 6
Medical Microbiology and Control of Infection 6
Hours of Business 7
Pathology Supplies 8
Electronic Requesting Through ICE ordercomms 8
Request cards 8
Blood collection 11
Important things to remember when taking blood 11
Labelling of specimens/sample 13
Date and time of samples 13
High Risk specimens 14
Specimen Transport 14
Transport to the laboratory within the Hospital (Trust Staff) 14
Transport of specimens from clinics and surgeries 14
Research and Development 15
Screening Programmes and other non-NHS work 15
Availability of Results 16
Turnaround Times 16
Reports 16
Out-of-hours service 17
DEPARTMENTAL SPECIFIC INFORMATION 20
CHEMICAL PATHOLOGY 20
Andrology 26
HAEMATOLOGY AND BLOOD TRANSFUSION 28
Anticoagulant Services 38
HISTOPATHOLOGY 40
MORTUARY 43
MEDICAL MICROBIOLOGY 48
How to get to Basingstoke & North Hampshire Hospital 61
Site Map 63
TEST INDEX 64
BACTERIOLOGY 64
CHEMICAL PATHOLOGY 70
HAEMATOLOGY 134
SEROLOGY 139
PREFACE
This guide has been prepared to inform the users of Basingstoke & North Hampshire Hospital Pathology Laboratories of which services are available and how to obtain the services required.
It is appreciated that with the ever increasing range of tests available it is difficult for the user to know which request form, specimen container, type of specimen and particular protocol is needed to obtain the specific investigation and result they require. Hopefully, this guide will address these difficulties. In addition to this type of information, the guide also contains lists of relevant telephone numbers to facilitate easy access to appropriate Consultants and other senior staff for advice as well as departmental numbers for result enquiries.
Any laboratory is, to a large extent, only as good as the user allows it to be. It is important that all request forms and specimen containers are labelled properly with the relevant demographic and clinical details. Care must also be taken to follow any necessary protocol where a result could otherwise be adversely affected. If any doubt exists, it is advisable to contact the appropriate Consultant or department who will be pleased to provide the necessary information.
Finally, any views that users may have about how this guide could be improved would be welcomed for incorporation into future editions. Please give these, preferably in writing to David Beacher, Quality Manager (mailto:).
Dr Nicki Hutchinson
on behalf of the Pathology Directorate
Seventh edition June 2011
INTRODUCTION
The pathology directorate offers services in five Consultant led divisions, namely chemical pathology, haematology with transfusion, histopathology with mortuary facilities, specialist haemophilia and medical microbiology with infection control. The laboratories are located on the ground floor (Level B) of the theatre block in the main hospital with further facilities downstairs on A floor (mainly microbiology and mortuary). Clinical haemophilia services are based in a separate unit near Parklands.
The directorate is an open-access service. Each department has to cope with a high workload and has to organise itself to provide urgent and emergency services as well as ensuring that all results reach the wards or GP surgeries with the minimum of delay. Because the type of work carried out varies considerably, some being labour intensive while some is automated, there are organisational differences from department to department. For example, there are different request cards for some departments and/or tests. If the appropriate request card is used and all the information required given, it enables the laboratory to provide an efficient service.
Finally, remember you are always welcome to visit the laboratory and if the staff can put a face to a name, this can only help to improve communication and the service for your patients.
PATHOLOGY MANAGEMENT
General Pathology
For general enquiries, complaints, comments, or to discuss service requirements/contracts.
Pathology Clinical Director, Dr. Nicki Hutchinson ext 3310
Pathology General Manager, Katie Bolam ext 2788
Pathology Quality Manager, David Beacher ext 3280
Pathology office for general enquiries and results ext 4751
Pathology administrator ext 3278
Mr Alex Kelly, computer manager ext 3288
Mr Shaun Goldsmith for ICE order comms issues: 07770967360
Pathology department fax (in office) 01256 314905
Blood Sciences
Includes Pathology specimen reception, Phlebotomy services, Haematology and Chemical Pathology laboratories and Transfusion services.
Mr Ian Savill, Blood Sciences laboratory manager ext 3283
Chemical Pathology
For consultant or technical advice including clinical advice and interpretation.
Dr. Martyn Knapp, Consultant Clinical Biochemist ext 3270 or 3285
Mr Robert Jupp, Consultant Clinical Biochemist ext 3270 or 3285
Secretary ext 3278
Mrs Catherine Wands, Lead BMS in Chemical Pathology ext 3284
Miss Sarah Lewendon, Point of Care co-ordinator ext 3288
Urgent requests or sweat tests (normal hours) ext 3284
Andrology (semen analysis) ext 3324
GTT appointments ext 4751
Consultant advice is available 24 hours a day from the on-call Biochemist (contacted by the hospital switchboard).
Haematology and Blood Transfusion
For clinical or technical enquiries, requests for urgent work, to arrange special tests, or anticoagulant services including clinical advice and interpretation.
Medical staff
Dr Alison Milne, Consultant Haematologist ext 3297
Mrs Helen Todd, secretary ext 3282
Dr Sylwia Simpson, Consultant Haematologist ext 3296
Dr. Katharine Lowndes, Consultant Haematologist ext 3282
Dr Ashok Roy, Associate Specialist ext 3200
Mrs Gill Knight, secretary ext 3279
Consultant clinical advice and interpretation is available 24 hours a day from the on-call Haematologist (contacted by bleep via the Hospital switchboard).
Other Haematology and Blood Transfusion staff
Mr Stephen Knight, Lead BMS in Haematology ext 3294
Mr Roger Chant, Transfusion Specialist Practitioner ext 4756
Dr Jane Needham, Principal BMS ext 3293
Haematology/Coagulation laboratory ext 3294
Transfusion laboratory ext 3290
Urgent requests - Haematology/Coagulation ext 3292
- Blood Transfusion ext 3290
Sister Vicki Warburton, Anticoagulant Nurse Practitioner ext 3295
Sister Jackie Schuster, Anticoagulant Nurse Practitioner ext 3295
Sister Niamh MacIndoe, Anticoagulant Nurse Practitioner ext 3295
Phlebotomy
Mrs Jenny Dykes, Phlebotomy services and training ext 3961
Histopathology
For clinical advice and interpretation, technical advice, histology reports or to arrange urgent investigations
Dr Hanan El-Mahallawi, Consultant Histopathologist ext 3298
Dr Ian Ilesley Consultant Histopathologist ext 3302
Dr Asmat Mustajab, Consultant Histopathologist ext 3301
Consultant’s secretaries ext 3271, ext 3533, ext 3640
Miss Alison Taylor, Department Manager ext 3280
Laboratory enquiries ext 3300
Mr William Chapman, Mortuary Manager ext 4749
Histopathology fax 01256 313273
NOTE – Please give four days notice of slide requests for MDT or other meetings
Medical Microbiology and Control of Infection
For consultant or technical advice, microbiology results, to arrange urgent investigations or for control of infection matters including clinical advice and interpretation.
Dr Nicki Hutchinson, Consultant Medical Microbiologist (bleep 2305) ext 3310
Dr Fatima El Bakri, Consultant Medical Microbiologist ext 3305
Dr Jorge Cepeda, Consultant Medical Microbiologist ext 3308
(Consultant on call available through switchboard out of hours)
Mr Dave Thomas, Laboratory Manager ext 3311
Laboratory enquiries ext 4904
Infection Control (bleep2356) or contact senior infection control nurses:-
Hazel Gray, Mobile: 07500990914 or Linda Swanson, Mobile: 0750099012
Hours of Business
Chemical Pathology –
Routine service Mon – Fri 08.00 – 20.00
On call service at all other times including weekends
Contact Chemical Pathology bleep 2303
Andrology service 08.30 - 14.00 Monday to Thursday
Point of Care Testing. Routine service Mon - Fri 09:00 - 17:30. On-call service at all other times, Point of Care Coordinator contact via switchboard
Haematology –
Routine service Mon – Fri 08.00 – 20.00
On call service at all other times including weekends
Contact Haematology bleep 2304
Phlebotomy -
Phlebotomy outpatients Mon – Fri 08.00 – 17.00
Phlebotomy service to BNHFT Wards Mon – Fri 07.00 – 11.00
Contact Phlebotomy supervisor for further information on Ext 3291.
Limited Saturday service for INPATIENTS ONLY, 07.00 – 11.00
Limited Sunday service for INPATIENTS ONLY, 07.00 – 11.00
(Limited relates to the following: Wessex Ward, E Floor and C Floor)
Microbiology –
Routine service Mon – Fri 09.00 – 17.30
Saturday 09.00 – 12.00
On call service Mon – Fri 17.30 – 09.00
Saturday 12.00 – Mon 09.00
Contact Microbiology On call Biomedical Scientist:
Monday to Sunday 9.00am Telephone: 07721 881673
Sunday 9.00am – Monday 9.00am Telephone: 07887 794673
Cellular Pathology –
Routine service 09.00 – 17.15
On call service: An on call service is available at the discretion of the Department Manager and the Consultant Pathologist
Please contact the department via switchboard
Mortuary –
Routine service Mon – Fri 08.00 – 16.00
On call service at all other times including weekends
Pathology Supplies
At the BNHFT a ward top-up system is operated by supplies. Additional stock may be ordered and collected directly from pathology stores during core hours.
Outside BNHFT orders can be made by fax, email or writing. These are dispatched as promptly as possible. However, please allow three working days for delivery. Urgent orders may be dispatched the same day within working hours. Service users are advised not to hoard supplies as stock is date-coded and issued on a rotational basis. For further information please contact Pathology reception.
Electronic Requesting Through ICE ordercomms
Internal Hospital Test Requests
Please follow the instruction detailed in the Trust standard operating procedure TP-GEN-ICEREQUEST, located on the Intranet, for requesting all Pathology tests. In the event of system failure please revert to the paper based request card system.
GP Test Requests
Please follow your local systems operating guide for requesting tests through the ICE system. There are 4 general GP systems covered, these are:- EMIS LV, EMIS PCS, VISION INPS & ISOFT. For EMIS LV, EMIS PCS & VISION Systems the ICE requesting procedure can be located on the GP section of the Trust Website.
http://www.northhampshire.nhs.uk/gps-doctors/referral-guidance/-useful-information/gp-e-requesting/
If an interruption occurs with ICE then please revert to the paper request form as supplied
Request cards
The request card is a crucial document. It is usually the only link between the laboratory staff and the ward staff or general practitioner responsible for a patient on whom a test has been requested. For efficient processing, all the information requested must be given in a legible form. Accurate patient identification is obviously of vital importance and wherever possible, please use a computer printed patient label on cards or pots. Most computer labels are not suitable for use on blood tubes as they cause jams in the processing equipment. This is not the case however with those GP practices that print 2-dimensional bar coded patient ID labels when the small labels associated can be used on blood tubes without problems
Requests for pathology tests will NOT be accepted unless there are three matching points of identification on both sample and request card. Acceptable data includes Full name, date of birth, NHS number, Hospital number or first line of the address. Incomplete or discrepant requests will be rejected and the requesting doctor informed. Laboratory staff are not authorised to make changes to cards or samples. NOTE there are slightly different and more stringent requirements for Blood Transfusion. Please specify specimen collection time and date on all samples and request cards.
Clinical information is essential for validation and interpretation of results and to enable initiation of further investigations where appropriate. If insufficient information is given, the Consultant Pathologists reserve the right to decline to perform the requested test.
Request cards must be signed by a doctor or requesting practitioner. Please print your name at the bottom of the request form to ensure that you can be contacted promptly with significant results or problems. And finally, we can always perform tests but it is very difficult to send back reports if you don’t say who the consultant/GP is and where.
Therefore the following legible information is required on the request card:
· Patient's full name - surname and forename (initials are not acceptable)
· Date of birth and sex of patient
· NHS number and, if known, hospital number
· Patient’s address including the postcode
· Patient’s contact telephone number
· The requesting clinician and location
· Relevant clinical information and any drug therapy
· The tests being requested
· Type of specimen with the date and time it was collected
· Indication if HIGH RISK status
Additional information may be required for some investigations ie “Special Haematology, Thrombophilia and Ante natal screening”. Please see separate departmental sections.
‘Unknown’ patients e.g. those admitted unconscious, unaccompanied and without documentation, should have their specimens identified with the casualty number. See the Trust Policy for Unconscious Patients.
Regrettably, specimens will be discarded if they are inadequately labelled, if the patient’s identification is in doubt, or if they have leaked and/or been contaminated.
Request cards for Blood Transfusion and/or blood grouping must have at least three identification points.
Essential
· Patient’s Full name - Surname and forename (initials are not acceptable)
· Date of birth
Plus one of the following
· NHS number
· Hospital number
· or in exceptional circumstances , patient’s address including post code
The labelling on the Request Card must match the labelling on the sample!
Also required is Collector's signature, date and time of collection and the signature of the requesting doctor
EXCEPTIONS
A&E shall use a unique patient number for patients who are brought in unconscious or unable to be identified. Follow trust procedure
Sexual Health shall use the unique patient number and date of birth due to patient confidentiality.