Procedure: Delivery of urgent samples / frozen sections to Cellular Pathology. and Wards
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1 Procedure: Delivery of urgent samples / frozen sections to Cellular Pathology Procedure serial number: CPSOP 12 Prepared by: H. J. Hemsworth Original issue date: 15/04/2009 Document review: Review Date Altered Y/N (Reason for change) Version number No. of pages Signed Next review 15/04/09 New Document H.J. Hemsworth 15/04/10 02/08/10 N H. J. Hemsworth Nov /9/10 Y A.Goodall Sept /1/201 2 No major change Karen Austin 24/1/ /12/13 More detailed info for taxi drivers. Addition of red phone. 27/01/15 Adding Web sites as a location and clarifying delivery route to reduce number of drivers visiting the mortuary Area of application: OUH Theatres and Wards Authorised by: Reviewed by: Helen Hemsworth Number & location of copies : 1. CSU Electronic Master File 2. Cellular Pathology Master SOP file Section B sent to the ORH switchboard for reference Read only files sent electronically to: 3. Cellular Pathology Web sites 4. Deputy Director of Operations, Cancer Clinical Centre, CH 5. Theatre Manager, Churchill Hospital 6. Theatre Manager JRII 7. Theatre Manager JRI (Gynae) 8. Renal Transplant Unit 9. Renal Ward 10. Wytham Ward, Churchill (SBTx) 11. City Sprint 12. Transport Coordinator Personnel requirement: Theatre staff Couriers/taxi drivers Porters Biomedical Scientist / Associate Practitioner / Biomedical Support Worker- Histopathology Anne Goodall 02/12/ /01/2019 YOU ARE INSTRUCTED TO READ THE FOLLOWING THOROUGHLY UNDER NO CIRCUMSTANCES ARE THESE INSTRUCTIONS TO BE AMENDED OR ALTERED IN ANY WAY OTHER THAN BY THE AUTHOR / SIGNATORY OR A REVIEWER AS IDENTIFIED IN CPP14 DOCUMENT CONTROL. Date 27/01/2015 Version Number 7.0 Page 1 of 8
2 COSHH (H&S) INFORMATION: N/A Linked procedural risk assessments: RA Histo 03 Use of formaldehyde RA Histo 38 High Risk Specimens. OUTLINE: Instructions for the safe delivery of urgent frozen section and renal biopsies to Cellular Pathology only To prevent delays due to incorrect delivery PRINCIPLE: To ensure that staff involved in sending extremely urgent specimens to Cellular Pathology can provide clear information for delivering the sample safely to the carrier, be they a porter, a taxi driver or a courier. This procedure is only for samples where a rapid result is required through frozen section (i.e. the patient is still under anaesthetic and further treatment is dependent on the Pathology report from the sample) and urgent renal biopsies. DO NOT USE THESE BOXES FOR ANY OTHER SAMPLES (e.g. this is not to be used for delivering bloods, urines, faecal material etc.) REQUIREMENTS: Mobile Telephone Contact numbers Map Identification badge Blue specimen box (see below) CPP20 Specimen Transport (available on Trust Intranet) Delivery Address 2 options Cellular Pathology or Return to the sender only Date 27/01/2015 Version Number 7.0 Page 2 of 8
3 URGENT CELLULAR PATHOLOGY RENALS OR FROZEN SECTIONS? Yes USE PALE BLUE BOXES No Non - Urgent Cellular Pathology samples use routine delivery processes Other specimen types: Refer to other laboratory instructions via the intranet Churchill site deliver to lab medicine Discuss with the Pathology speciality lead: Direct dial or via secretaries 20498/99/500 during Core hours Or switchboard out of hours Between and 16.45? Yes Cancelled No Update the laboratory On call service covering urgent renal biopsies small bowel transplant biopsies Book with the Cellular Pathology laboratory supplying: Patient name Specimen Type Name of caller Contact number/bleep Expected date and time of delivery Telephone extension: Arrange delivery: Contact the technician on call (Histology Biomedical Scientist) via switchboard JRII: Via hatch do not leave without speaking to a lab person WEST WING & GYNAE: Via porters CHURCHILL SITE: City sprint: Account number: M40006 Supply map & directions from CPSOP 12: Section C & Appendix 1a and 1b Date 27/01/2015 Version Number 7.0 Page 3 of 8
4 METHOD: SECTION A: PROCEDURE WITHIN THE CORE HOURS IMPORTANT INFORMATION: The following information relates to samples to be delivered within the core working hours for Cellular Pathology. The core hours are: 8.30 until (deliveries after are likely to cross over into the out of hours samples) Do not follow these instructions outside of these hours as this will be detrimental to the patient and the sample because the appropriate staff will not be available. For specimens outside of these hours please refer to the information in SECTION B. Planned Frozen Section s or renal biopsies 1. Contact the relevant Consultant Pathologist prior to surgery to book and discuss the case for frozen section or renal biopsy. This is essential to the provision of the service. a. Contact numbers are available via switchboard or the intranet b. If assistance is required with nominating a relevant pathologist contact histology secretaries on 20498/ 99/ Contact the Biomedical Scientist (laboratory staff, BMS) to book the frozen section/ renal biopsy with the lab. This is also essential to the provision of the service. a. Call (2) (or (2) in the unlikely event that your call is unanswered) b. Provide the following pieces of information, these are critical to ensure the process is efficient: Patient Name Specimen Type Name of caller and their contact number/bleep Expected date and time of specimen arrival in Cellular Pathology 3. Arrange the delivery of the sample via the appropriate specimen delivery service. From the Churchill theatres and renal/ transplant wards this will be via 001 Taxis or City Sprint. You will need to provide an account number. From the West Wing and Gynae theatres this will be via porters From JRII theatres this will be directly to the specimen hatch. 4. Ensure that clear contact details are present on the request form for telephone the results from the pathologist. 5. Frozen sections and urgent renal biopsies only must be placed inside a pale blue specimen box for transportation to cellular pathology. See photo above. a. Ensure the correct delivery address is visible i.e. cell path from the changeable address window on the front of the box. b. Blue transport boxes are located at designated areas within each site; JRII theatres in the specimen bucket/ pot storage room JRI theatres (gynae) in the specimen bucket/ pot storage room Churchill theatres in the specimen room West wing theatres level 1- on the fridge with the booking in book level 0- in the specimen bucket/ pot storage room Renal Transplant unit in the nurses room Renal ward in the doctors room Date 27/01/2015 Version Number 7.0 Page 4 of 8
5 6. Ensure the sample is ready for collection at the arranged pick up point and the person delivering the sample to Cellular Pathology is aware that: a. This is NOT a routine sample and requires a rapid result. b. It can ONLY be delivered to the Cut up room of Cellular Pathology, JRH, level 1 delivery elsewhere will delay the procedure and will be detrimental to the patient c. Taxi drivers must follow the directions in appendix 1 (delivery & directions) Specific instructions for taxi drivers/ couriers see SECTION C. d. Specimens from JRII theatres, Gynae theatres and West Wing theatres must be handed directly to a member of staff through the specimen reception hatch. Do not leave the specimen in the hatch without speaking to a member of the specimen reception team Incidental finding during surgery- Unable to pre book a Frozen Section. 7. Telephone Cellular Pathology as soon as possible to alert the lab staff and relevant pathologist of the impending sample. a. Use the telephone numbers listed in point 1 and 2 if necessary. b. Without prior warning of the sample a Consultant Pathologists will need to be found at short notice who can diagnose and report the sample. Significant delay to the procedure will occur if the sample is not pre booked. c. Without prior warning additional delays may be caused as the required equipment may be unavailable. d. Where possible, always pre book frozen sections. e. Un booked frozen sections cannot be dealt with out of the core hours of the lab normally 8. Follow from step 3 above SECTION B: PROCEDURE OUTSIDE THE CORE HOURS IMPORTANT INFORMATION Frozen sections due to arrive in the department after will fall outside of the core hours of the department as it takes approx. 15mins to prepare the sample for diagnosis. Frozen sections arriving in the department after this time will become an on-call request. The Trust has not authorised an on call system for the Consultant Pathologists. However, a frozen section may be processed provided a Consultant Pathologist has agreed to be available to diagnose and report the sample and a BMS has been contacted in time to prepare the sample. Only a Consultant Pathologist can agree to an out of hours frozen section a. The BMS is not the correct person to agree b. It is not the BMS responsibility to contact a Consultant Pathologist. 1. Contact the relevant Consultant Pathologist via JRH switchboard. a. Should it prove difficult to contact a Pathologist from the relevant speciality, a Consultant Pathologist from another speciality must be found who will accept the specimen. 2. Provide information stated in point 2b Section A and arrange transport/ pick up/ drop off directly with the pathologist, 3. The pathologist must contact the on call BMS via the switchboard (known to switchboard as the technician on call ) 4. Follow points 3 onwards in Section A for delivery instructions. Date 27/01/2015 Version Number 7.0 Page 5 of 8
6 SECTION C: SPECIFIC INSTRUCTIONS FOR TAXI DRIVERS Pick Up 1. From Churchill theatres pick up sample from the Main Reception desk This sample will be an emergency frozen section for immediate delivery. The patient will remain under general anaesthetic until a result is obtained. The result of this sample may change the course of the operation so immediate delivery of the sample is imperative. 2. From Renal Ward or Renal Transplant Unit pick up sample from main desk in designated area. This sample will be an urgent renal biopsy for immediate delivery. The clinicians will require a result the same day and these samples take approx. 3 hours to process for diagnosis. The patient may have renal failure or undergoing transplant rejection so immediate delivery of the sample is crucial. 3. The sample will be inside a pale blue specimen transport box. Cellular Pathology Contact number Delivery Address 2 options Cellular Pathology or Return to the sender only Drop Off 4. Take sample to the Cellular Pathology entrance at the rear of the hospital. See appendix 1a for detailed written instructions of delivery point. See appendix 1b for map of delivery point. 5. Contact a member of laboratory staff using the designated telephone. This is the red handset located on the wall inside the entrance, beyond the glass doors, on the left hand side. The telephone is clearly labelled for delivery of emergency blue boxes only. Lift the handset and the telephone will connect directly to the specimen reception (cut-up) room. Let the lab staff know who you are, and that you are delivering a sample in a blue specimen box. Additional Information 6. In the event of an incident which may hinder or delay the delivery of the specimen box ie vehicle accident, contact histopathology specimen reception on the telephone number in delivery address window on the front of the box. This number is also on the top of the box (2) Due to the nature of the samples the likelihood of a formalin spillage is extremely low. Frozen sections are always fresh and are double bagged within the specimen box. Renal biopsies are sent in a tiny volume of fixative (formalin based) and are double bagged within the specimen box. Authorised staff must open the specimen transport box Specimen transport box is padded and sealed posing no risk of sample leakage. Date 27/01/2015 Version Number 7.0 Page 6 of 8
7 APPENDIX 1a: DELIVERY and DIRECTIONS OF SPECIMENS FOR FROZEN SECTION/URGENT ATTENTION ONLY to CELLULAR PATHOLOGY, JRH on level 1 IMPORTANT INFORMATION 1. Deliver the samples for frozen section directly to a BMS who works in Cellular Pathology 2. Deliver the sample to the Cellular Pathology entrance. See appendix 1b 3. DO NOT deliver the sample anywhere else except to Cellular Pathology i.e. do not deliver to JR porters desk, main reception level 2 or level 4 specimen reception Directions from Headley Way: 4. Turn into the hospital site and follow signs to car park 1 by: a. Turning left at the first roundabout (The West wing building and children s hospital are behind the roundabout) b. Taking the next right, uphill (still following signs for car park 1) c. Bearing right at the road fork towards car park 1 5. DO NOT turn into car park 1 6. Turn right at the next entrance after car park 1 (This is a small road between the trauma unit and staff car park L, signposted for the Coroner s office) 7. Park in the spaces at the bottom of the slope opposite the Trauma Unit next to the Coroner s Office 8. Walk through the grey slatted gates marked No parking beyond this point See map 1b and follow Do not park beyond the gates as it must be kept clear for undertakers cars and is a fire access point Do not go to the mortuary entrance 9. Walk towards the building straight ahead then head right to the entrance 10. Enter the hospital through the glass doors circled on the map 1b 11. Continue through the next set of doors straight ahead. 12. Pick up the red telephone located on the wall on the left just inside the door This will connect you directly to the specimen reception room in cellular pathology. 13. Inform the staff member that you are delivering an urgent sample in a blue box 14. Wait for the staff member to collect the blue box who will confirm they are from cellular pathology Never hand the sample to any other personnel Do not deliver specimen to the Mortuary staff Staff from theatres also use this entrance but are not authorised to accept samples for Cellular Pathology Date 27/01/2015 Version Number 7.0 Page 7 of 8
8 APPENDIX 1b: MAP CAR PARK 1 P Mortuary Delivery point- Cellular Pathology Entrance Only for samples in a blue specimen box Red telephone located on the wall inside entrance. To access Cellular Pathology with a samples for a frozen section Contact numbers are located on the address panel on the front of the blue box Date 27/01/2015 Version Number 7.0 Page 8 of 8
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