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United States Government Work, uncopyrighted, public-domain,
DRAFT COPY ONLY. This document does not necessarily represent the views
or policies of any United States Government agency.
This document is provided "as is", without warranty of any kind,
express or implied, including but not limited to the warranties
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or in connection with the document or the use or other dealings
made with the document.
PRINCIPLE OF THE TEST.
The Histology Laboratory is responsible for processing all tissues
obtained at surgery, outpatient clinics, and postmortems in this hospital.
SPECIMEN REQUIRED.
All human tissue excised at surgery, outpatient clinics,
fresh or in fixative, along with a filled-out Tissue Examination Form
(U. S. Standard Form 515, USSF515).
REAGENTS, INSTRUMENTATION.
Plastic containers.
Tissue Tek VIP®5 Vacuum Infiltration Processor.
Neutral 10% buffered formalin.
70% Flex Solution.
80% Flex Solution.
95% Flex Solution.
100% Flex Solution.
Clearing Solution.
Paraffin.
Decalcifying solution (RDO),
Hematoxylin and eosin stain.
Microtome.
Water bath.
Alcoholic iodine solution.
5% sodium thiosulfate.
13% Thioacetamide.
Fluted filter paper.
STEP-BY-STEP DESCRIPTION.
1. Protective disposable gloves must be worn during accessioning.
When specimens are brought into the histology laboratory, each specimen
must have a requisition sheet. The specimen will not be accepted
without a requisition sheet (U. S. Standard Form 515, USSF515).
The requisition should be checked by the Attending pathologist,
the Resident pathologist or the technician. The requisition
sheet must include the following information:
1.1. The full name printed on the requisition sheet, and the
full name printed on the specimen container should be the same.
1.2. The printed, full social security number of the patient.
1.3. The patient's date of birth.
1.4. The patient location (the floor or clinic area).
1.5. The submitting doctor's signature.
2. There is a logbook for laboratory staff to register all specimens brought
to the histology area (4D-124). In the logbook, the date and the patient's
name are noted. A technician signs and verifies the number of parts received.
3. Specimens are recorded in a paper accession logbook and in the
computer. Each specimen is assigned an accession number, that is recorded
in both locations.
4. For patient safety, it is the policy of the Baltimore VAMHCS
to use printed or stamped name labels, that include: full name, full social
security number, and date of birth. This information is verified at seven
steps in the processing of the specimen:
4.1. Receipt of specimen by pathology technician, pathology resident,
or attending pathologist.
4.2. Login of specimen by pathology technician, pathology resident,
or attending pathologist.
4.3. Gross dictation of specimen by pathology resident.
4.4. Transcription of gross dictation by clerk typist.
4.5. Examination of slides and review/correction of gross dictation
by pathology resident.
4.6. Diagnosis of specimen at daily quality assurance conference.
4.7. Esignature of final diagnosis by attending pathologist.
REFERENCES.
1. Berte LM, Charlton BJ, Kirkley B, Schiffgens J,
Wilson JI, Woodcock SM.
Clinical Laboratory Technical Procedure Manuals;
Approved Guideline -- Fourth Edition.
NCCLS Document GP2-A4. 2002;2(5):.
ISBN 1-56238-458-9, 64 pages.
National Committee for Clinical Laboratory Standards (NCCLS).
940 West Valley Road, Suite 1400. Wayne, PA 19087-1898.
... presents the important components of writing and managing procedures
for the clinical laboratory.
2. Hoeltge GA, Dynek DA, Delahunty DC, McClatchey KD,
Rabinovitch A, Robinowitz M, Travers EM.
National Committee for Clinical Laboratory Standards (NCCLS).
Clinical Laboratory Technical Procedure Manuals. Third Edition.
Approved Guideline GP2-A3. 1996;16(15):.
3. Rosai J.
Rosai and Ackerman's Surgical Pathology. Ninth Edition.
St Louis: C.V. Mosby. 2004;:.
ISBN: 0323013422, 3080 pages.
4. Mills SE, Carter D, Greenson JK, Oberman HA,
Reuter VE, Stoler MH, eds.
Sternberg's Diagnostic Surgical Pathology. Fourth Edition.
New York: Lippincott Williams & Wilkins. 2004;:.
ISBN: 0781740517, 3089 pages.