Use of the Blood Sciences 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 all of the following information:

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)
tests required
brief, relevant clinical details
the requesting doctor’s name (printed) and an associated bleep or telephone number
the date and time of the sample

Failure to provide all of 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 manually entered.

The request form must be accompanied by the correct sample - which should be transported to the laboratory sealed within the special specimen bag, and attached to the request form.

Important information on blood samples

‘High risk’ samples

Samples from patients with blood borne virus diseases present 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.

Patient-collected samples

Where samples are collected at home by the patient the information for the collection procedure, and the sample container will be provided by the requesting clinical area. Examples include 24 hour urine collections and post-vasectomy semen analysis.

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. This is to prevent over-ordering of the same tests. This reduces analysis costs and ensures the best care for patients.

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 recognised (such as pre-analytical variables and 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.

Managing uncertainty in clinical laboratory results

All pathology assays have an inherent degree of uncertainty. Whilst many factors are well recognised (such as pre-analytical variables and analytical precision) some occur by random error alone.

Users should bear in mind these uncertainties when interpreting any laboratory value.

Please refer to document on Measurement of Uncertainty in the link below for further information and a table of values per test

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.

Uncertainty of Measurement document