M1 Specimen Processing Flashcards
(38 cards)
What category of items are required to assess specimen acceptability?
- Description, e.g., site or source? ie. right leg; type? ie. swab
- Preparation & collection: LIM Shared Health
- Number; type; volume
- Container
- Clinical History
- Time of Collection
How many specimens per requisition should there be?
One specimen per requisition.
What are the first three specimen processing steps?
- Specimen arrives
- Time stamped
- Requisition versus sample is checked to see if they match and its priority.
Once the sample is considered valid (matching checked, etc.) what are the next three specimen processing steps?
- Labeling of sample, plates, and slides (as applicable).
- Accession in computer: # + barcode assigned
- Specimen placed in fridge if needed
What are the remaining last three specimen processing steps?
- Pre-treatment (Centrifuge, elution, etc.)
- Planting and incubation.
- Reading and reporting gram stains.
For general prioritizing guidelines what specimens are critical and need a gram stain STAT in 1 hour?
- Blood cultures (to the blood machine asap),
- CSF (always STAT)
- Sterile fluids
What specimens are typically unpreserved?
- Wounds drainage,
- stool,
- Sputum,
- Urine (if they go to the fridge they can wait, no gram stain)
What specimens are preserved?
- Stool (ova and parasites),
- Swabs in transport media (TM) - Gram stain STAT 4 hours for some
- Some organisms might need special treatment (gonococci)
Will another sample from the same patient, same site, same day be accepted in the micro lab?
No, more than 1 sample from same site/day is rejected.
Are leaking specimens a cause for rejection (what could be the exception)?
Yes, Leaking specimens are rejected (excludes irreplaceable sterile fluid samples: TBD with doctor)
Are samples submitted in preservatives a cause for rejection (what could be the exception)?
Yes, Samples submitted in preservative and/or wrong preservative are rejected (excludes formalin for parasites, boric acid for urine)
Why are fluid samples submitted in a syringe not accepted in the micro lab?
Fluids in a syringe are a safety concern and therefore are rejected.
Why might a sample for testing anaerobes be rejected?
Request for anaerobes from inappropriate sites
Can you list some of the etiological agents the Dr. is to notify the lab if they are suspected in the sample?
All physicians are required to notify lab if they suspect the following etiological agents in specimens to be sent to the laboratory:
- Bacillus anthracis,
- Bordetella pertussis,
- Brucella spp.,
- Francisella tularensis,
- Burkholderia pseudomallei,
- Yersinia pestis, and
- dimorphic fungus like Blastomyces dermatitidis, Coccidioides immitis, Histoplasma capsulatum, Paracoccidioides brasiliensis.
What containers are accepted in the micro lab?
Containers are to be sterile and appropriate for specimen.
Non-sterile or inappropriate containers are rejected.
What are the procedures to follow when a specimen is rejected? What about records?
*Notify physician/nurse.
*Request new specimen
*Call physician or charge nurse to obtain clarifying info
*Inform physician or charge nurse of problem and suggest solution
*Accession sample and hold specimen-labeled as UNACCEPTABLE
All records pertaining to lack of acceptability must be maintained.
What is done before planting a specimen?
Macroscopic observations are made and recorded: eg. bloody, purulent, etc.
Can a specimen be processed if it has inadequate volume supplied?
No specimens with inadequate volume are rejected.
What can happen if a sample is not brought to the lab in a timely manner?
Delay in transport or transported inappropriately (no refrigeration) are cause for rejection.
Where must all specimens be planted and why?
All specimens must be planted in a Biosafety cabinet to
- protect the worker from aerosol exposure
- the sample from environmental contamination and
- the environment.
What PPE are required when working at a biosafety cabinet?
Staff working in a biosafety cabinet must wear:
1. Gown and
2. Gloves
The gloves must be removed when exiting the biosafety cabinet or when the gloves become soiled or lose their integrity.
All standard precautions procedures apply when handling patient samples and sharps policies are also enforced.
What is the media checked for prior to planting?
- Examine plates for expiration and contamination before inoculation
- All media prepared in Microbiology is labelled with expiration date and name
What do you label the media with and how?
- Label media with accession number and date. Do not obscure the name and expiration date
Does it matter what order you inoculate the media (e.g. plates) in and why?
Yes, arrange labeled plates in order from least to most selective
- Inoculate least inhibitory first to prevent carryover of inhibitory substances ie. most routine aerobic culture BA→ CA → Mac
