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CBS Labs – Specimen Collection

Specimen Collection

Specimen Collection and Preparation

The quality of laboratory tests depends greatly upon the individual specimen, and how it is collected, managed and sent to the lab. To ensure the best possible results, please complete the following steps.

Collect specimen as follows:

  1. Collect specimen(s).
  2. Label specimens immediately.
  3. Clearly label each tube or specimen with specific patient identification, date and time of collection, source of specimen.

Unlabeled or improperly identified specimens will cause delays in processing and may require re-collection of the specimen. A fully completed CBS Labs  form must accompany each specimen or set of specimens. If required information is missing, CBS Labs will contact the client before continuing with the testing process.

Specimen identification policy

CBS Labs’s specimen identification policy states that all specimens received for testing must be correctly and adequately labeled to assure positive identification.

Person-specific identifiers may include:

  • Patient’s full name
  • Patient’s Social Security number
  • CBS Labs requisition number
  • Medical record number
  • Date of birth

Specimens are considered mislabeled when the person-specific identifiers on the specimen do not match information on the accompanying requisition or other paperwork. In this situation, CBS Labs will recommend that a new specimen be obtained, if feasible.

Specimens unsuitable for analysis

Some specimens cannot be analyzed with accurate results. Reasons include missing patient information and degraded or incorrectly-identified specimens. CBS Labs will make every attempt to notify clients of problems as soon as possible.

Specimen volume

Each test has a preferred volume and a minimum volume.

The preferred volume optimizes testing and allows the laboratory to quickly process specimen containers, present the containers to the instruments, perform the test and repeat it if necessary.

Many of our testing processes are fully automated. The preferred volume allows hands-free testing and our quickest turnaround time. Preferred volumes also allow for repeat testing, dilution or other specimen manipulations if needed. If at all possible, please submit the preferred specimen volume.

When the venipuncture is technically difficult or the patient is at risk of complications from blood loss (e.g., pediatric patients), smaller volumes may be necessary. The specimen minimum is the amount required to perform an assay once, including instrument and container dead space.

CBS Labs makes every possible effort to successfully test patients’ specimens. If you have concerns about submitting a specimen for testing, please call us.

Blood

Many laboratory tests are performed on blood obtained from a peripheral (venous) source. Please follow the blood-draw, separation and transport instructions.

  • Draw blood specimen using venipuncture technique, if possible
  • Vacutainer®-type tubes should fill automatically to the proper amount.
  • If using a syringe, refer to manufacturer’s guide or call Client Services.

If possible, draw tubes in the following order for optimum results:

  • Blood culture bottles
  • Blue top tube—Citrate anticoagulant
  • Red top tube—No additive
  • Gold top tube—gel additive
  • Green top tube-Heparin anticoagulant
  • Lavender top tube-EDTA anticoagulant
  • Gray top tube—Fluoride or Oxalate anticoagulant
  • Gently invert all tubes 5-10 times immediately after filling.
  • Immediately identify the tube with the patient-specific identifiers by affixing a label, writing the patient’s name on the tube or affixing a requisition number.
  • Allow the serum gel tube to clot for a minimum of 15 minutes but not longer than 60 minutes.
  • Centrifuge serum gel tube for 10 minutes at 3,000 RPM.
  • Place all specimens in biohazard bags with properly completed CBS Labs requisition forms in the outer pocket.
  • Specimens are now ready for transport to CBS Labs.

Fasting specimens

  • The patient may not eat anything for at least 12-14 hours before the blood is drawn.
  • The patient may drink only water. No coffee, tea, soda or chewing gum is permitted.
  • The patient may take prescribed medications.

Urine collection

Routine urinalysis: urine collection cup

  • To avoid contamination, do not touch the inside of the cup or the cap of the urine collection cup.
  • Unscrew the cap of the urine collection cup. Place cap on the counter with the inside of the lid facing upwards.

Cleanse with Towelettes® as follows:

Male: Wipe head of penis in single motion with one towelette. Repeat with remaining towelette(s). If not circumcised, hold foreskin back before cleaning. Have patient urinate small amount into toilet or bedpan.

Female: Separate labia. Wipe inner labial folds front to back in single motion with one towelette. Wipe down through center of labial folds with remaining towelette(s). Keep labia separated and have patient urinate small amount into toilet or bedpan.

  • Place cup under stream and have patient continue to urinate into cup. Collect specimen.
  • Replace cap on cup. Tighten cap securely. Label and refrigerate until courier pickup.

Clean catch (preferred collection method):

  • Open Urine and Collection Transport Kit provided. Remove cup and towelette.
  • To avoid contamination, do not touch the inside of the cup or the cap of the urine collection cup.
  • Unscrew the cap of the urine collection cup. Place cap on the counter with the inside of the lid facing upwards.

Cleanse with Towelettes® as follows:

Male: Wipe head of penis in single motion with one towelette. Repeat with remaining towelette(s). If not circumcised, hold foreskin back before cleaning. Have patient urinate small amount into toilet or bedpan.

Female: Separate labia. Wipe inner labial folds front to back in single motion with one towelette. Wipe down through center of labial folds with remaining towelette(s). Keep labia separated and have patient urinate small amount into toilet or bedpan.

  • Place cup under stream and have patient continue to urinate into cup. Collect specimen.
  • Replace cap on cup. Caution: sharp needle located under cap label. Do not remove label from cap.
  • Label and refrigerate until courier pickup.

The small grey-top tube included in the urine cup container kit is not suitable for routine urinalysis. It contains boric acid as a preservative and is to be used when a urine culture is requested.

Urine culture: Grey-top transport tube

  • Collect urine specimen using clean catch method as outlined above.
  • Please use the grey-top urine-culture transport tube included in the collection kit. This grey-top tube contains boric acid as a preservative and will aid in the preservation of the specimen if delay is anticipated.
  • Mix specimen.
  • Peel back the yellow label and place grey-top urine collection tube rubber topside down over the needle port. Press down until approximately 3.0-4.0 cc of specimen has transferred to the transport tube. Mix or shake tube well.
  • Replace the yellow label over the needle port.
  • Label specimen. Refrigeration is preferred but not required.

Caution: This grey-top tube is not the same as the grey-top potassium oxalate/sodium fluoride tube used for blood draws. The two are not interchangeable.

Note: If urinalysis is not required in addition to a urine culture, discard the urine container cup and submit only the grey-top urine culture transport tube. This will help eliminate confusion.

24-hour urine collection

CBS Labs provides 24-hour urine collection containers. Use the following procedure for the correct specimen preparation and collection:

  • Plan collection period so the specimen can be delivered to CBS Labs within a day after completion.
  • Provide the patient with a labeled, sterile 24-hour collection container. Multiple 24-hour urine tests that share the same preservative may be collected using the same specimen. Notify patient of any potentially hazardous preservative.
  • To begin the timed collection period, have patient urinate to empty his or her bladder. Discard this specimen.
  • Write on the container the date and beginning time of the collection. The collection period begins at this time.
  • Collect all urine during the timed collection period. (If even one specimen is lost, the results will not be valid.)
  • At the end of the timed period, have the patient urinate to empty his or her bladder and add this specimen to the collection container.
  • Write on the container the date and ending time of the collection.
  • Keep the collection container in the refrigerator during the collection period and until courier pickup.

Note: Routine urinalysis and/or urine culture and sensitivity cannot be collected during the 24-hour collection period. Collect specimen either before or after the 24-hour urine collection.

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