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Prevention of Errors During Gross Examination

It is the responsibility of each person who works with the specimen to maintain the integrity of patient and specimen identification throughout the entire process from collection to diagnosis. Errors generated during the collection and grossing process are termed pre-analytic errors. The grossing phase is a verification of patient and specimen information prior to the analytic phase of histology.
To prevent the most common errors, the grossing personnel should do the following:
  1. Match the requisition information with the specimen container information.
  2. Match the cassette number or bar code with the requisition AND specimen container.
  3. Gross one container at one time to prevent errors.
  4. Examine specimen containers and forceps to ensure the entire specimen is submitted in the cassette.
  5. Rinse/clean grossing tools after each specimen to prevent carry-over or contamination.
  6. Choose the proper cassette for various sized samples: small specimens require mesh cassettes; large fatty excisions require routine cassettes with larger opening for better processing.
  7. Gross according to a standardized and accepted protocol for the laboratory.
  8. Work with one cassette at a time when a specimen requires many cassettes.
  9. Close the cassette completely so the specimen does not escape during processing.
  10. Document the number of cassettes submitted for each patient on the gross dictation or gross sheet.