Specimen Integrity

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The page below is a sample from the LabCE course Medical Courier Safety. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Specimen Integrity

Couriers must maintain the necessary conditions such as temperatures, protection from light, or simply preventing breakage during the specimen transport process. If you do not follow the requirements during handling and transportation of specimens, then the quality of these specimens may be compromised, and the testing results will be incorrect. This may result in a delay in turnaround time and a very unhappy client when the specimen may be rejected as unsatisfactory. A worst case scenario would result in the physician acting on these incorrect test results and treating or performing unnecessary surgery on the patient.
It is important that you are willing to ask questions when necessary to avoid making mistakes that will cause the specimen to be unacceptable for testing. Always understand that it is not always possible to recollect every type of specimen.
If a specimen is lost or rendered unusable for testing by poor handling by a courier, your organization may be legally liable for damages and lawsuits may be brought by both the testing laboratory and/or the patient.
Some specimens are date and/or time sensitive. The physician orders specimens to be collected in the following ways, using what is known as a priority:
  • A STAT priority indicates a specimen that must be collected immediately with the testing performed as soon as possible to avoid harm to the patient. Many lab tests can be ordered as STAT if the physician feels the result is needed faster than usual.
  • A routine priority indicates a specimen to be collected on the next draw or collection schedule, with the testing performed within a designated time frame (such as within four hours). Most laboratory tests are ordered as routine.
  • A timed priority indicates a specimen that the doctor has designated a specific draw/collection time for, and the testing will be performed as soon as possible. An example of specimens collected in the timed specimen category can include therapeutic drug monitoring tests (TDMs). These are drugs that are used to treat patient conditions/symptoms. Some therapeutic drugs are toxic to different body systems and must be monitored to assure that appropriate treatment levels of the drug are achieved and to prevent toxic levels from accumulating in the patient. Examples include antibiotics (such as gentamycin or Vancomycin), cardiac drugs (such as digoxin), and anti-seizure drugs (such as dilantin).
There are certain specimens that will need protection from all light sources, including room light and sunlight. These specimens should be protected from light as soon as they are collected from the patient by the healthcare professional who collects them. Examples of specimens needing protection from light include bilirubin, vitamin B12, and folate. To protect specimens from light, aluminum foil wraps or amber-colored collection tubes can be used. Wash cloths or paper towels are not acceptable for light protection, as they do not prevent light from reaching the tubes.