Laboratory specimen transport refers to the procedures involved in transporting clinical samples or specimens from patient care areas to the laboratory for analysis and diagnostic testing. It is a crucial but often overlooked aspect of the total testing process that ensures accurate and timely test results.
Efficient and standardized transport of specimens is essential for delivering quality healthcare. Mishandling of specimens during transport can lead to inaccurate test results or delayed diagnoses. Proper transport helps maintain sample integrity and stability until testing and analysis can be performed in the lab. Factors like time, temperature, container type, and transportation method all impact specimen quality.
Laboratory testing provides key diagnostic information to identify disease early, guide treatment decisions, and monitor patient condition. Around 70-80% of medical diagnoses are influenced by laboratory test results. Without reliable specimen transport, labs cannot produce accurate results that clinicians need for optimal patient care. A breakdown anywhere in the transport chain compromises the quality of laboratory services.
This article will walk through the important steps involved in transporting clinical specimens to the laboratory. We will cover best practices that safeguard sample integrity during the pre-analytic phase. Understanding proper specimen handling procedures is vital for anyone involved in collecting, transporting, or processing patient samples. Proper transport prevents delays in diagnosis and treatment due to compromised or rejected specimens. Continue reading this blog post by Apollo Couriers to understand laboratory specimen transport systems in 8 simple steps.
- 1 Pre-Collection Planning
- 2 Specimen Collection
- 3 Handling and Transportation
- 4 Documentation and Requisitions
- 5 Receiving Specimens in the Lab
- 6 Specimen Processing and Testing
- 7 Reporting Results
- 8 Frequently Asked Questions
- 9 Conclusion
Before any laboratory specimen transport, there are important steps that need to be taken to ensure proper handling, transport, and testing. This planning phase is critical for achieving accurate results.
First, the healthcare provider must determine what tests need to be performed and order them accordingly. This may involve looking at the patient’s symptoms, medical history, and suspected diagnoses. The provider will select the appropriate tests to order.
Next, the tubes or containers used for collecting the specimen need to be properly labeled. The label should include the patient’s full name, a second identifier such as date of birth or medical record number, the date and time of collection, and any special instructions. Pre-printed labels can help streamline this process.
Additionally, the required laboratory forms and requisitions should be prepared and filled out in advance when possible. These forms provide information about the patient, the tests being ordered, and any clinically relevant details to inform the processing and testing. The forms should be checked for accuracy and completeness.
Taking the time for proper pre-collection planning helps set up smooth downstream processes. Following test ordering protocols, readying supplies, and completing paperwork reduces the chances of errors and delays once the specimen collection begins. With these preparatory steps done, the phlebotomist can focus on the task of drawing or obtaining the sample.
Properly collecting specimens is a critical step in the laboratory testing process.
Here are some key steps for collecting common specimen types:
- Use the correct tube type (lavender top EDTA, red top, etc.) based on the ordered tests.
- Ensure tubes are well mixed after collection, not clotted.
- Use proper phlebotomy techniques to avoid hemolysis.
- Label tubes at the patient bedside with two patient identifiers.
- Follow any special instructions like fasting requirements.
- Provide a clean specimen cup. Have patient wash hands prior to collection.
- Collect a midstream, clean-catch urine sample. Discard first part of stream.
- Ensure the specimen cup is properly labeled with two patient IDs.
- Refrigerate cup after collection if cannot transport to lab within two hours.
- Provide a stool collection kit with scoop and transport container.
- Collect small, pea-sized portion of stool. Do not contaminate with urine or water.
- Make sure collection container is sealed tightly.
- Label container and complete requisition with two patient identifiers.
- Have patient rinse mouth with water to minimize food/oral contaminants.
- Instruct deep cough from lungs to produce specimen.
- Collect early morning samples if possible.
- Keep cool before transport to limit bacterial overgrowth.
Proper techniques for specimen collection preserve sample integrity and allow for accurate test results. Always refer to your organization’s procedures for the specimen types required.
Handling and Transportation
Properly handling and transporting specimens is critical to maintaining sample integrity and obtaining accurate test results. Here are some key steps:
- Maintain proper temperature control. Each specimen has specific temperature requirements during transport to avoid degradation. For example, routine clinical chemistry tests need refrigeration at 2-8°C while samples for microbiological culture should be kept at room temperature. Use insulated containers, cooling elements, and monitored systems as needed.
- Use the right specimen containers. The tube or vial should be made of suitable material, properly labeled, and sealed tightly to avoid leakage or contamination. Sterile containers may be required for microbiological samples. Follow any special instructions provided in the test requisition form.
- Prevent contamination and cross-contamination. Wear gloves when handling specimens and change between sample collections. Make sure containers remain sealed during transport. Separate specimens appropriately to avoid contact between biohazardous materials. Clean carrying cases regularly.
- Cushion specimens to avoid breakage or spillage. Use absorbent material to pad glass tubes and vials. Special segmented foam trays can isolate individual specimen containers. Sturdy outer transport bags, boxes or buckets help prevent impacts during transit.
- Track chain of custody. Maintain a custody log listing each person handling the specimen through transport and receipt. Lock transport containers that contain hazardous or sensitive samples.
Proper handling prevents erroneous results or lost specimens. With good temperature control, containers, and anti-contamination techniques, samples will arrive at the laboratory intact and suitable for analysis.
Documentation and Requisitions
Proper documentation and labeling is critical for accurate specimen analysis and result reporting.
Requisition forms contain patient information as well as details on what tests the physician has ordered. Common information on requisitions includes:
- Patient name, date of birth, gender
- Date and time of specimen collection
- Type of specimen collected
- Tests to be performed
- Any relevant clinical information
Requisitions may be paper forms or electronic orders in a laboratory information system. Paper forms should accompany the specimen. Electronic orders must be accessible to laboratory staff.
All specimens must be clearly labeled with at minimum:
- Patient name
- Date and time of collection
- Type of specimen
Labels are typically pre-printed by the lab to ensure all required information is present. If hand-writing is required, the label should be legible and use indelible ink that will not run or smudge.
Matching patient ID on labels, forms, and specimens is critical. Mislabeled or unlabeled specimens can lead to serious patient harm if tested and results reported incorrectly.
Receiving Specimens in the Lab
Once specimens arrive at the laboratory, proper procedures must be followed to maintain integrity of the samples and ensure accurate testing and results.
The first step when receiving specimens is to log them into the laboratory information system (LIS). The person receiving the specimens will:
- Carefully match each specimen container with the test requisition form and patient information.
- Verify that the patient name, ID number, test orders, and other details match on the specimen and paperwork.
- Note any discrepancies or issues, like damaged or leaked containers.
- Log the specimens into the LIS using barcodes or manual entry, following the laboratory’s procedures.
It’s crucial that specimens are transported and arrive within the proper temperature range. Upon receipt:
- The temperature of refrigerated or frozen specimens must be checked right away.
- The acceptable arrival temperature range depends on the type of specimen and testing.
- If specimens are outside the acceptable temperature range upon arrival, they may be rejected and new specimens requested.
After logging in and checking the temperature, the next step is accessioning:
- Each specimen container is assigned an individual accession or ID number in the LIS.
- This links the physical specimen to the electronic record and test orders.
- Accession stickers may be placed on the tubes before sending specimens to processing and testing benches.
- Proper accessioning provides specimen traceability.
Following laboratory standard operating procedures for receiving specimens helps ensure accurate testing and timely results reporting.
Specimen Processing and Testing
Once specimens arrive in the lab, they undergo several steps to prepare them for analysis and testing:
- Specimen accessioning – The lab documents receipt of the specimen and verifies all paperwork is complete. Specimens are assigned a unique lab ID number.
- Specimen preparation – Depending on the test, the specimen may need to be centrifuged, aliquoted, diluted, or undergo other preparatory steps.
- Analysis and testing – The prepared specimen undergoes analysis and testing using sophisticated lab equipment like spectrophotometers, automated chemistry analyzers, microscopes, and more. Testing methods vary greatly depending on the specimen type and test being performed.
- Result validation – Rigorous quality control processes are followed to validate the test result before release. Controls and calibrators are tested alongside patient samples to ensure accuracy. Technical staff review results and may re-test questionable findings.
Proper specimen processing is critical for accurate test results. Labs follow strict protocols to avoid pre-analytical errors and maintain the integrity of specimens during preparation and testing procedures. Careful handling preserves specimen quality so that analytic testing equipment can reliably detect any abnormalities and provide physicians with dependable diagnostic information.
The final and crucial step in the laboratory specimen transport process is reviewing, approving, and releasing the test results. This requires careful attention and quality control by laboratory staff.
Once testing is complete, the laboratory technologist will review the results for accuracy and completeness. They will check that the results make sense based on the test methodology and the patient’s condition. Any questionable or inconsistent findings may need to be investigated further before releasing results.
The laboratory director, pathologist, or other authorized physician will need to validate and sign off on final test results before they can be released. They will interpret the findings, taking into account the patient’s clinical history. Approving and releasing results is a huge responsibility, as treatment decisions and patient care depend on accurate and timely reporting.
Finally, the laboratory will release the results to the ordering physician or care team, typically via phone, fax, printed report, or electronic medical record system. Clear communication of the test results is essential, along with any cautions in interpreting borderline or abnormal findings. The goal is to provide clinically actionable results that lead to proper diagnosis and treatment for the patient.
Proper reporting, review, and release of results completes the full cycle of successful laboratory specimen transport and testing. It enables evidence-based patient care guided by laboratory medicine.
Specimen Storage and Retention
Proper storage and retention of laboratory specimens is a critical part of the testing process.
Even after testing is completed, there are several reasons why specimens may need to be saved for a period of time:
Storing Extra Specimen Material
Often extra amounts of the collected sample are retained in case additional testing needs to be done or to verify unusual results. Having leftover specimen material allows labs to go back and perform:
- Repeat testing if the initial result is unclear or needs confirmation
- Additional tests that weren’t originally ordered but become necessary based on the initial findings
- Specialized or reflex testing that may only be done in certain situations
- Future testing with new methods as technology advances
Storing extra amounts of specimens ensures there will be sufficient material for these situations. Samples like blood and urine are typically stable for 1-2 weeks refrigerated or frozen. Swabs, sputum, and tissue may also be held for several weeks.
Laboratories should have established policies on retaining specimens for specified periods. Retention times depend on the sample type, the performed tests, and legal requirements. For example:
- Specimens involved in proficiency testing programs may need retention for up to 2 years
- Forensic/criminal case samples often require retention for the full statute of limitations period
- Newborn screening blood spots are kept 18-23 years based on state laws
- Infectious disease samples with public health significance are stored 5-10 years
Proper labeling, tracking, and periodic auditing of stored specimens is necessary. At the end of the retention period, specimens must be discarded using safe biohazard protocols. Setting retention policies ensures laboratories follow consistent, standardized practices for storing extra specimen materials.
Frequently Asked Questions
Laboratory specimen transport refers to the process of moving samples collected from patients (such as blood, urine, tissues, or swabs) from the point of collection to a laboratory for analysis. This process must maintain the integrity of the specimen to ensure accurate test results.
Proper transport is crucial because it ensures the specimen’s integrity is maintained, preventing contamination, degradation, or changes in the specimen that could lead to inaccurate test results. It’s essential for patient safety, correct diagnosis, and effective treatment.
Specimens should be labeled with the patient’s full name, date of birth, specimen collection date and time, and type of specimen. This information ensures accurate identification and proper handling throughout the transport process.
The proper handling, packaging, and laboratory specimens transport is crucial to ensuring the quality of test results. Mistakes made during transport and delivery can lead to hemolyzed, contaminated, or otherwise compromised specimens, which in turn can negatively impact patient diagnosis, treatment, and care.
Laboratories rely on intact, properly collected specimens to perform accurate analysis and provide physicians with the information needed to make informed clinical decisions. If specimens are mishandled or arrive at the lab in suboptimal condition, the resulting test results may not reflect the patient’s true status. At best, compromised specimens will need to be recollected, delaying diagnosis and care. At worst, erroneous test results could lead to improper patient management.
By following the key steps outlined in this guide – from pre-collection planning to final specimen analysis and storage – healthcare workers can help prevent transport errors and maintain specimen integrity. While each sample type has specific handling needs, all require careful labeling, transportation in sealed containers, temperature control, and prompt delivery under established chain of custody procedures.
When transport protocols are followed consistently, laboratories receive high-quality specimens that allow them to successfully perform testing and report accurate results. This allows physicians to correctly diagnose conditions, identify effective treatments, and make informed patient care decisions that improve health outcomes. Proper specimen transport practices are an essential component of the overall quality management system here at Apollo Couriers that allows clinical laboratories to fulfill their role in modern healthcare. Schedule your medical deliveries today.