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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
of merchantability, fitness for a particular purpose and
non-infringement. In no event shall the authors be liable
for any claim, damages or other liability, whether in an
action of contract, tort or otherwise, arising from, out of,
or in connection with the document or the use or other dealings
made with the document.
See also: Main objectives: 1.
Receipt of Specimens: 2,
3.
Specimen Accessioning: 4,
5.
VistA® Computer: 1,
7.
PRINCIPLE OF THE TEST.
The Histology Laboratory is responsible for processing all tissues obtained
at surgery, outpatient clinics, and postmortems in this hospital.
Proper accessioning of specimens must be performed, in order to provide
accurate clinicopathologic correlations.
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. If two specimens are received on a patient with two separate
Tissue Examination Forms,
then the type of procedure and the doctor's name should be noted.
If the procedures were done by two different doctors,
then these specimens should be assigned two different accession numbers.
2. If multiple specimens are received on a patient with one
Tissue Examination Form,
then the specimen jars are labeled
with the accession number, plus numbers in ascending order,
beginning with the number 1. For example, if three jars
are received on John Smith, the accession number will be put
on the jars, with the first jar labeled 1,
the second 2, the third 3 and so on, if needed.
3. Usually if there are multiple jars, then the jars will have been
labeled before they are received in histology, with numbers to correspond
with the order of the tissues that are on the Tissue Examination Form
(U. S. Standard Form 515, USSF515).
This numerical order should always be followed when labeling jars.
4. If multiple specimens are received on a patient, and the type
of specimen and not a number is written on a jar, then these jars are
assigned numbers in histology to correspond with what is on the
requisition.
5. If a specimen is received unlabeled, or if a requisition
is not completed properly, the doctor who performed the procedure
must be notified immediately. Someone from their office or the ward
must come to the Histology Laboratory, pick up the specimen, carry it back
to the doctor, and have the information verified with an initial.
After the doctor is notified of a rejection, and if the problem
is not corrected within a week, the specimen is discarded,
and the circumstances are recorded. The case is then reported
to the Invasive Procedures Review Committee (IPRC).
6. Accession numbers should be written
on the jars so as not to interfere with any information on the jar.
7. If more than one cassette is needed for a single specimen,
the cassettes are labeled with block numbers that follow the accession
numbers (e.g., BSP 05-352, 1-4).
8. Requisitions are covered in
Procedure 5: Instructions for Submitting Tissue.
9. In clinical pathology, there is an orderable test,
MISCELLANEOUS, named RECEIVED UNLABELED. This enables
easier tracking of incompletely identified specimens.
RECEIVED UNLABELED appears on the SEND OUT list,
for daily review by an attending pathologist:
NAME: RECEIVED UNLABELED TYPE: NEITHER
SUBSCRIPT: CHEM, HEM, TOX, SER, RIA, ETC.
LOCATION (DATA NAME): CH;512620;1 UNIQUE ACCESSION #: YES
UNIQUE COLLECTION SAMPLE: NO FIELD: DD(63.04,512620,
HIGHEST URGENCY ALLOWED: ROUTINE REQUIRED TEST: YES
FORCED URGENCY: ROUTINE REQUIRED COMMENT: ORDER COMMENT
COMBINE TEST DURING ORDER: YES PRINT NAME: UNL
PRINT ORDER: 974.1 DATA NAME: UNLABELED
SITE/SPECIMEN: SERUM
SYNONYM: UNLABELED SPECIMEN
INSTITUTION: BALTIMORE MD VAMC ACCESSION AREA: BA-SENDOUT
INSTITUTION: ZZ FORT HOWARD ACCESSION AREA: BA-SENDOUT
INSTITUTION: PERRY POINT ACCESSION AREA: BA-SENDOUT
NATIONAL VA LAB CODE: Misc Chem Test 1
RESULT NLT CODE: Misc Chem Test 1
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.