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Sample / Requisition Acceptance Criteria

Diagnostic Services: Winnipeg Centre

Canadian Blood Services, Diagnostic Services Laboratories reserve the right to refuse samples that do not meet minimum standards.

References:
Canadian Standards Association CAN/CSA-Z902-10, February 2010
AABB Standards for Blood Banks and Transfusion Services.

Downloadable: MB Sample Requisition Acceptance Criteria (PDF)
                           Sample Requirements for Neonate Collection (PDF)

Minimum Sample / Requisition Labelling Requirements

  • Patient last and first name (key identifier)
  • PHN - Personal Health Number or other unique identifying number (key identifier)
  • Date and time of sample collection

Sample / Requisition Labelling Rejections

  • Unlabelled sample or requisition
  • Key Identifier information is missing, incorrect or discrepant on the sample and / or requisition
  • Sample is over labelled with more than one name
  • Correction fluid is used to correct errors

Requisitions

All specimens submitted to the laboratory must have an accompanying requisition.

Perinatal Testing
Request for Perinatal Testing

  • Use a name plate or print the patient’s PHN* (or if not available, indicate an alternate unique identification number in this field), LAST name*, FIRST name* and date of birth (DOB).
    *Key identifier – sample will not be processed if incorrect or missing.
  • Ensure all First and Last name of the Physician/Midwife or “copy to” information is present and legible. If an information label is used, ensure that it provides information indicated on the corresponding section of the requisition.
  • Ensure that all Mother’s information is complete when sending in Father samples. Also ensure that the appropriate sample type for the submitted sample is checked off.
  • Indicate the Expected Date of Delivery and Hospital for Delivery for patient in order to prevent delays in testing.
  • Indicate whether a RhIG injection has been given during this pregnancy and the date of that injection to prevent delays in testing.
  • In order to prevent delays in result reporting, it is important that the physician / midwife’s First and Last name is complete including the clinic name, address, phone and fax numbers.
  • Complete all information in the “Specimen Collection” section.
  • The phlebotomist must print his or her name and the date and time of collection.

Request for Cord / Neonate Blood Testing

  • Cord sample: Use maternal name plate or print the PHN* (or if not available, indicate an alternate unique identification number in this field), LAST name*, FIRST name* and date of birth (DOB).
    Neonate sample: Use neonate name plate or print the PHN* (or if not available, indicate an alternate unique identification number in this field), LAST name*, FIRST name* and date of birth (DOB).
    *Key identifier – sample will not be processed if incorrect or missing.
  • Ensure First and Last name of the physician/authorized health care provider or “copy to” information is present and legible. If an information label is used, ensure that it provides information indicated on the corresponding section of the requisition.
  • Ensure that the appropriate sample type for the submitted sample is checked off.
  • Ensure that all Mother’s information is completed when sending in Neonate samples.
  • Complete all information in the “Specimen Collection” section.
  • The phlebotomist must print his or her name and the date and time of collection.

Pre-Transfusion Testing
Request for Blood Components

  • Use a name plate or print the patient’s PHN* (or if not available, indicate an alternate unique identification number in this field), LAST name*, FIRST name* and date of birth (DOB).
    *Key identifier – sample will not be processed if incorrect or missing.
  • Indicate number of red cell units required and any special requirements (i.e. irradiated Anti-CMV negative, autologous, neonatal protocol).
  • Indicate test(s) ordered and priority.
  • Indicate date and time components are required.
  • Ensure First and Last name of the Physician/ Authorized health care provider is present and legible.
  • Provide the patient’s history including diagnosis, transfusion and RhIG administration history
  • Complete all information in the “Specimen Collection” section.
  • The phlebotomist must print his or her name and the date and time of collection.
  • Retain the Collection Record copy of the requisition and submit the Blood Services copy with sample(s).

Request for Miscellaneous Testing

  • Use a name plate or print the patient’s PHN* (or if not available, indicate an alternate unique identification number in this field), LAST name*, FIRST name* and date of birth (DOB).
    *Key identifier – sample will not be processed if incorrect or missing.
  • Indicate test(s) ordered.
  • Ensure First and Last name of the Physician / Authorized Health Care provider is present and legible.
  • Provide the patient history including diagnosis, transfusion and RhIG administration history. If applicable, provide the BMT workup information.
  • Complete all information in the “Specimen Collection” section.
  • The phlebotomist must print his or her name and the date and time of collection.
  • Retain the Collection Record copy of the requisition and submit the Blood Services copy with sample(s).

Transfusion Reaction Investigation

  • Use a name plate or print the patient’s PHN* (or if not available, indicate an alternate unique identification number in this field), LAST name*, FIRST name* and date of birth (DOB).
    *Key identifier – sample will not be processed if incorrect or missing.
  • Ensure all sections of the form are completed in a legible and detailed manner.
  • Provide all required information so that the investigation can be completed without delay.
  • Complete all information in the “Specimen Collection” section.
  • The phlebotomist must print his or her name and the date and time of collection.
  • Ensure both the Nursing and Facility Blood Bank clerical checks have been completed and that this is documented on the form. This will prevent delays in testing.
  • Retain the Chart Copy and Blood Bank Copy of the requisition and submit the Manitoba Health copy and the Blood Services copy with sample(s).

Platelet Immunology Testing

Platelet Immunology Requisition

  • Use a name plate or print the patient’s PHN* (or if not available, indicate an alternate unique identification number in this field), LAST name*, FIRST name* and date of birth (DOB).
    *Key identifier – sample will not be processed if incorrect or missing.
  • Ensure the “Mail Report to” information is present and legible.
  • Indicate test(s) ordered. Certain tests as indicated on the requisition require that prior arrangements be made with the laboratory.
  • Provide the patient’s history including diagnosis and IVIG or ATG administration.
  • Complete all information in the “Specimen Collection” section.
  • The phlebotomist must print his or her name and the date and time of collection.
  • Retain the Collection Record copy of the requisition and submit the Blood Services Copy, Patient Chart Copy and Referring Physician Copy with the sample(s).