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Chemical Pathology, Haematology & Immunology

The combined department of chemical pathology, haematology and immunology (CHI) is based on the fifth Floor of the Royal Derby Hospital in a modern purpose-built facilities.

The department provides a full analytical and advisory service.

Laboratory opening hours

The combined laboratory at the Royal Derby Hospital is open 24 hours per day for the receipt of samples.

The core-time for all laboratories within the department is 08.45 through to 17.15, Monday to Friday, when all services are available.

Outside of these core hours the department offers a limited service for analysis.

General enquiries can be made by telephoning 01332-789400

Clinical Biochemistry/Haematology/Immunology advice and interpretation can be obtained by calling 01332-789400. Out-of-hours contact the hospital switchboard to be transferred to the appropriate consultant of laboratory personel.

Services are offered by the laboratory?

The Combined department offers 24/7 support to the hospital and general practitioners for the analysis of various samples. Analysis and interpretation on :- Organ profile analysis such as renal, liver and bone, cerebral spinal fluid, urine and fluid, drug analysis and blood gases. The department also offers full blood count analysis, antibody investigations and specialist analysis on a wide range of analytes which can be found on the test database.

Request to the laboratory

Please use electronic requesting wherever possible.

Each specimen sent to the laboratory must be accompanied by the relevant request form. It is vital that the form is completed legibly and as accurately and fully as possible. Failure to do so may lead to specimens being inappropriately dealt with or not being analysed at all. It is the responsibility of the requesting medical officer to ensure that the forms are completed correctly.

Routine chemical pathology, haematology and immunology tests can be requested on the combined multi-part request form if electronic requesting is not used. Separate single part forms must be use for blood transfusion, Kleihauer testing and antenatal screening requests.

Request forms and samples from patients that present a risk of infection from blood bourne viruses should be clearly labelled with yellow "Risk of Infection" stickers.

Request forms for blood transfusion must contain all the relevant information available and be signed by the requesting medical officer or authorised nurse. This is a medico-legal requirement.

Requesting additional tests on to sample that have been received by the laboratory

Due to the stability of some analytes there are time limits within which the laboratory can accept requesting for further testing.

The attachment on the stability of samples can be found on the main pathology page which outlines the maximum sample age for which additional test requests may be accepted on a blood or urine sample received by the combined department of Chemical Pathology, Haematology and Immunology.

Addressograph Labels

If used on request forms, addressograph labels must be affixed to all three copies of the multi -part form. Alternatively, a ball point pen, pressed firmly, should be used to fill out forms. Addressograph labels should not be used on any sample containers; please note that samples with addressograph labels for crossmatching will not be accepted under any circumstances and will require a repeat sample to be taken. Users are referred to the Trust's written policy on taking blood samples.

Specimen labelling

The sample container must be clearly labelled with a minimum of the patient's surname, forename, and one of the following three items, the hospital number, NHS number or date of birth.

These details should exactly match the information supplied on the request form.

This is to allow the unequivocal identification of the patient. If this minimum requirement is not met this may lead to sample rejection.

The sample should also be labelled with the ward or department, and the date and preferably time the sample was taken.

For medico-legal and safety reasons unlabelled or mislabelled specimens must always be repeated where possible.

 Important: Blood transfusion samples must be fully labelled by hand and signed by the person obtaining the sample. There must be four patient identifiers that match on both the sample and the request form these are surname, forename, DOB plus one of the following: hospital number / address / NHS number.

Urgent requests

The laboratories can process a limited number of tests urgently. The urgent repertoire is the same as the out of hours service.

Urgent samples must be placed in a red "urgent sample" bag, supplies of which can be obtained from pathology stores. This service must not be abused. For the range of tests available urgently please see the table at the bottom of this page.

No phone call is required for these requests if samples are placed in red bags, unless there is a particular problem with the sample or specific conditions relating to the request. The laboratory will process these tests within 1 hour of receipt.

Appending "urgent" or "please phone" on the request form will not give the request priority.

Other tests are available urgently during normal working hours but only by prior discussion with the laboratory.

Please note:- This range of tests, when handled non-urgently (with the exception of the tests listed under the "after discussion with a consultant" column) are normally processed within four hours of receipt for inpatients and within one working day of receipt for GP and outpatient requests.

Immunology urgent requests

All urgent immunology tests that are required urgently must first be discussed with the Immunology Department on 01332 788502 or 788501. These samples need to be received by the laboratory by 2 pm and again should be placed in a red bag to aid identification. Results can usually be obtained within one working day of receipt of the sample.

Delivery of samples to the laboratory

Samples should be sent to the laboratory with minimum delay. Delays in sample delivery to the laboratory can compromise the accuracy of many analyses. Where blood serum is required for routine analysis, centrifugation should occur within 6 hours. Samples more than six hours old can look normal but may already begin to show increasing potassium and falling glucose concentrations. If the container is undated the reported results may be grossly misleading. ALWAYS put the time and date the sample was taken on the request form. 

For details of correct sample handling for individual tests see the Pathology Test Database.

Reporting of results

Printed results are distributed by internal post when completed and are available via computer using the iCM Clinical Manager system. GP reports are returned by the laboratory courier service to the relevant surgery and also electronically via Lab Links. Results will be telephoned when it has been thought that they indicate that a patient may need immediate medical attention.

Turnaround times

We aim to achieve the stated turnaround time for 95% of requests. For the turnaround time for individual tests see the Pathology Test Database.

Haematology and chemical pathology out of hours service

During the out-of-hours period, two biomedical scientists (BMS) are on duty at the Royal Derby Hospital site to respond to all haematology, blood transfusion and chemical pathology emergency requests for the hospitals in the district. A limited number of investigations are available during these periods. Requests for non-urgent investigations during the out-of-hours service period will be initially processed and usually analysed during the next working day.

These urgent, out-of-hours samples should be sent to the laboratory in Red Bags and will be processed in the same manner as an urgent samples in normal working hours, i.e., within one hour of receipt. If investigations are required more urgently, the BMS should be contacted by bleep. For cross matching the BMS should be contacted every time. Other tests not generally available on demand will require prior discussion and agreement with consultant staff who can be contacted via the BMS or switchboard.

For the range of tests available during the out-of hours period please see the table below.

Tests available out of hours / on an urgent basis                                                      

Albumin ALP Glucose The below should be discussed first with a consultant
ALT, AST, GGT (LFTs) INR  
Amylase Iron (overdose only) Digoxin 
Bicarbonate  KCCT Lithium
Bilirubin Magnesium Methotrexate 
Calcium Malaria screen Phenytoin
Carboxyhaemoglobin Osmolality Theophylline
CK/Troponin T Paracetamol Xanthochromia
Crossmatch/Group & Save Phosphate  
CSF Glucose/Protein Salicylate  
D-dimer bHCG  
ESR U/E  
FBC Urate  
Glandular fever Sickle screen  
Gentamicin        
Vancomycin - **Samples processed up to 10pm after which contact the on-call Lab scientist  Ammonia (please contact lab before collecting sample)  
Amikacin - ** Lactate (please contact lab before collecting sample)  

Referral of Specimens to other laboratories

The range of assays covered by Derby Pathology is not exhaustive, and there is a regular requirement to send samples for specialist tests to other centres. Where a test is referred to another centre this is indicated on the test database, and the laboratory name is provided. the full addresses of referral laboratories Derby Pathology uses are available on request from the appropriate department.

 

Last modified: 26/03/2015