Which of the following instructions should a phlebotomist provide to a patient who is collecting a urine specimen for culture?

The quality of your specimen is critical to the accuracy of your test results.

Questions?

Contact the lab at 252-808-6061

Preparation

If you had a barium swallow, you must delay collection until the barium has passed from your system. If possible, avoid the following within 48 hours before stool collection: Pepto Bismol, Maalox, mineral oil, antacids (Rolaids, Tums), Kaopectate.

Number To Collect

Collect one specimen per day unless otherwise instructed.

How To Collect The Specimen(s)

1. Avoiding contact with urine, pass stool directly into the stool cup OR pass stool into a large clean container (such as a cut out milk jug) OR onto a newspaper placed under the seat of the toilet. Transfer entire specimen into the stool cup using the tongue depressor provided or other handy implement (such as a plastic spoon). If your stools are loose, pass directly into a container, not onto newspaper.
2. Label the stool cup with your full name, date and time of collection.
3. Submit the specimen to the lab within two hours of collection.

If you cannot transport the specimen to the lab within two hours, follow specimen handling requirements marked below:

• Clostridium DifficileRefrigerate specimen and submit within 24 hours.
• Culture For PathogensPlace specimen into transport media by adding stool to the vial until the fluid rises to the red line. Replace the cap and mix gently. Label the container with your name, date and time of collection. If the specimen is bloody, indicate this by writing the word "bloody" on the label. Leave the vial at room temp and submit within 24 hrs.
• Stool For WBCNo transport media is available to preserve WBC's, submission of specimen within 24 hrs is very important.
• Ova & ParasitesPlace specimen into both vials of the transport media by adding stool to each until the fluid level rises to the black arrow. Replace the caps and mix gently. Label each container with your name, date and time of collection, and mark the appropriate block for the specimen appearance. Leave the vials at room temp and submit within 24 hrs.
• Occult Blood***Refrigerate and submit within 24 hrs. See separate list of dietary substances that may interfere with this test.

Occult Blood Testing on Stool Specimens

Please bring your physician order with the specimens and register in the Carteret General Outpatient Registration Department, if you have not already done so. Drop off specimen at the Lab Department or at the OP Center (7:30am to 3:00pm) near Patient Registration.

Number To Collect

Collect one per day unless otherwise instructed. Do only one test per bowel movement.

How To Collect The Specimen(s)

1. Avoiding contact with urine, pass stool directly into a large clean container (such as a cut out milk jug) OR onto a newspaper placed under the seat of the toilet. If your stools are loose, pass directly into a container, not onto newspaper.
2. Using the stick provided, scoop a small amount of stool and rub on the white circle inside the test card.
3. Label the test card with your full name, date and time of collection of the specimen.
4. Return the test card(s) with the test orders as soon as conveniently possible and at least within 48 hours of collection.

Patient Preparation

If you had a BARIUM SWALLOW, you MUST DELAY collection until the barium has passed from your system.
If possible, avoid the following foods, derivatives, and supplements for 72 hours before specimen collection

False negative test results may be caused by:

• Vitamin C (ascorbic acid)
• Antacids (e.g. Pepto Bismol, Maalox, mineral oil, Rolaids, Tums, Kaopectate)

False positive test results may be caused by:

• Red meat
• Peroxidase-rich vegetables and fruits (turnips, horseradish, artichokes, mushrooms, radishes, broccoli, bean sprouts, cauliflower, apples, oranges, bananas, cantaloupes, grapes)
• Alcohol and aspirin (especially if taken together)
• Therapeutic iron
• Other gastric irritants (steroids, rauwolfia derivatives, all nonsteroidal anti-inflammatory drugs, colchicine)

UC Irvine Pathology Services has established a uniform policy for specimen acceptance/rejection that:

• Has a positive impact on patient care
• Protects specimen quality
• Eliminates risk of exposure to the healthcare worker
• Complies with all accreditation standards

• Patient name
• Patient medical record number, with check digit
• Patient location
• Collection date and time
• Specimen type and/or source
• Test required (note any special handling required)
• Ordering physician

For patient safety, it is essential that the following be adhered to when submitting blood specimens for CROSSMATCHING purposes. Use special pink-top (EDTA) tubes.

1. Take a Crossmatch/Transfusion form, patient printed labels with the patient's first and last name, patient file number (PF#) or medical record number (MR#), and 1 pink-top (EDTA) tube to the patient's bedside.
2. Verify the patient's identity by asking the patient to state and spell his/her name, if able, while comparing the patient's identification band with the addressographed Crossmatch/Transfusion form and the patient's printed label.
3. The patient's name and PF# or MR# must be obtained from the patient's identification wristband. If the patient does not have a wristband, a wristband must be obtained prior to drawing the patient's blood.
4. Write the following data on the patient's printed or computer-generated gummed label at the bedside:
   • Date of phlebotomy
   • Time of phlebotomy
   • Legibly printed last name of phlebotomist
5. Affix the patient's printed gummed label to the specimen tube at the patient's bedside.
6. Send the labeled specimen tube with the Crossmatch/Transfusion form to the Blood Bank.

If the Blood Bank does not have a previous ABO/Rh on file for the patient, and the patient's initial blood type is other than type O, the Blood Bank will request a second sample to be collected for an ABO/Rh confirmation.

Failure to properly label the tubes will require that the specimens be redrawn. If the patient requires blood as an emergency and another sample cannot be drawn, an Emergency Release Form must be signed for uncrossmatched group O blood.

Specimens must be accompanied with a specimen transmittal or clinic encounter form that must match the specimen label. All handwritten requisitions accompanying specimens must have the following legible information:

• Last, first, and middle name of patient
• Medical record number (8 digits)
• Patient’s date of birth
• Last and first name of ordering physician
• Nursing station or clinic originating requestTest(s) or procedure(s) requestedSpecimen source and body site
• Date and time of specimen collection

All patient specimens MUST be placed in biohazard bags for transport to the Laboratory.

Laboratory procedures will not be performed on unacceptable specimens. Specimens collected using the incorrect tube type and transport material will not be tested. Specimens received showing evidence of leakage will not be tested. The nursing station from which the specimen originated will be notified. 

Mislabeled Specimens

Specimens received unlabeled, double labeled, or with a requisition bearing a name and/or medical record number different than what is affixed to the specimen will not be tested. The patient’s nurse and/or physician will be notified to recollect the specimen.

• Any specimen is unlabeled if the container holding the specimen (test tube, urine container, surgical specimen container, etc.) does not have the patient’s first and last name, medical record number, collection date and time, specimen type, and test required on it.
• A specimen is mislabeled if it arrives in the laboratory with a requisition bearing different names on the requisition and the label OR if the name in the computer does not match the label. The laboratory will consider a mislabeled specimen an unlabeled specimen.
• Blood Bank sample labels (crossmatch or type & hold) must be handwritten. Addressograph labels must not be placed on crossmatch specimens.

A specimen is incompletely labeled if some of the required information is missing:

• If the name and the medical record number are missing, the specimen will be considered unlabeled and handled as such.
• If there is any other information missing, the location where the specimen originated will be called to supply the information.

Specimens identified as precious specimens such as ascites fluid, amniotic fluid, cerebrospinal fluid, joint fluid, pleural fluid, surgical tissue/aspirate and certain timed specimens where the specimen cannot be recollected without undue harm to the patient will be tested only if the following conditions have been satisfied:

• The patient’s physician must be notified. He/she must agree to accept responsibility for the specimen and give written authorization for testing.
• In addition, the pathologist on call must be notified. He or she must review the circumstances and give written authorization for testing.A licensed caregiver designated by the patient’s physician must identify and correctly label the specimen.
• It will be documented in the laboratory computer system that the test was performed on an unlabeled specimen so that this information appears on the preliminary and final reports.

The Blood Bank requires a new specimen for each unlabeled or mislabeled specimen, no exceptions.