Specimen Preparation for Analysis

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Table of Contents

Introduction
Preparation of Specimens for Analysis
The Assessment of Test and Sample Appropriateness
The Ways of Handling of Unsatisfactory Samples
Pathological Conditions and Principles Used for Their Diagnosis
Conclusion
References

Introduction

One of the major objectives of Al-Rahba hospital’s laboratories is to eliminate the inappropriate specimen collection since it may have an adverse impact on the patients’ wellbeing. If a specimen is not prepared in the correct way, a patient may be prescribed unsuitable treatment, which may lead to health deterioration. Therefore, Al-Rahba laboratories do their best to arrange appropriate specimen collection so as to provide their customers with the best treatment outcomes.

Preparation of Specimens for Analysis

The initial step of proper preparation of specimens is their correct collection. Further, upon arrival to the laboratory, each sample needs to contain a properly filled request form (1). The suitability of specimens is analyzed according to several factors that may be identified during pre-analytic, analytic, and post-analytic processes. Based on the following four factors, laboratory specialists decide whether to accept or reject specimens:

issues with specimen labeling;
requisitioning problems;
integrity issues regarding specimens;
result integrity problems.

The Assessment of Test and Sample Appropriateness

Laboratory workers need to evaluate whether the samples are suitable for analysis based on such factors as patient identification, proper transportation, and, most importantly, the specimens themselves (2). The following factors indicate that specimen should not be accepted:

a sample is not labeled and does not provide appropriate patient identification;
a specimen is mislabeled and provides incorrect identification;
a sample type or container is inappropriate;
the quantity of gathered material is insufficient;
specimens are leaking, clotted, or heavily hemolyzed;
sample transportation is not proper;
a request form is not filled in correctly (time or date of collection is wrong);
there is some inconsistency between the sample and request form labels;
there has been a laboratory accident.

The Ways of Handling of Unsatisfactory Samples

The first thing that laboratory specialists need to do when they notice an unsatisfactory sample establishes the place where discrepancy occurred. Further, they either confirm or check sample requirements by applying a suitable policy. The next step is contacting the doctor or nurse in charge and informing them that there is a deficiency in the sample. The physician or nurse should tell the laboratory technician what measures should be taken. There may be a request to redraw the sample or submit a request form in an appropriate way.

In case if a new sample is needed, the original specimen request has to be annulled. The re-order process has to be registered under a new laboratory accession number. When the second sample of a different kind is needed to carry out a requisition, the technologist should inform the responsible physician or nurse about the missing sample. In such a case, the test is removed from the requisition. In the request form, it is necessary to include data about the notified person as well as the cause of the deletion. The deleted test has to be re-ordered after the arrival of a new sample. If a requisition does not match the sample, it is necessary to contact the nursing station so that its representative would come to the laboratory and make relevant corrections.

Pathological Conditions and Principles Used for Their Diagnosis

One of the pathological conditions routinely diagnosed in the Al-Rahba hematology laboratory is malaria. The equipment needed for such an analysis includes pre-cleaned slides (for capillary blood) or tubes (for venous blood), methanol for fixing the film, and a microscope for identification of the types of malaria parasites (3). The first thing needed to be done is the preparation of a blood smear. Next, the technologist uses malaria antigen screening. Such antigen test helps to observe antigens released by the parasite in the patient’s blood. There are two common types of antigens: HRP2 (Histidine-rich protein 2) and LDH (lactate dehydrogenase). To perform an antigen test, a lab worker locates a drop of blood at the end of the test that is covered with a test buffer solvent. When blood moves up the test strip, the parasite antigen is caught by the antibody. When this antigen connects with another antibody joined to colloidal gold, there will be a positive bond indicated on the test.

Another pathological condition that is frequently diagnosed in our laboratory is anemia. The equipment used for the analysis of blood on anemia is the same as for malaria tests. A laboratory specialist prepares blood smears and then uses them to identify anemia in the patient’s blood. The most typical way of checking the blood for anemia is a test called a complete blood count (CBC) (4). With the help of this test, a lab technician can check the patient’s hematocrit and hemoglobin, low levels of which signify anemia. Hematocrit is the ratio of red cells in the blood. Hemoglobin is the iron-rich protein molecule carrying oxygen to body tissues.

Conclusion

Appropriate preparation of specimens for analysis in a laboratory is crucial to any hospital’s work. In Al-Rahba, particular attention is paid to sample preparation measures. If a specimen is not appropriate, there is a list of policies to follow in order to eliminate the possibility of false results.

References

Health Authority of Abu Dhabi. HAAD clinical laboratory standards. Abu-Dhabi: HAAD; 2011.
Hill RH, Finster DC. Laboratory safety for chemistry students. 2nd ed. Hoboken: Wiley; 2016.
Centers for Disease Control and Prevention. Laboratory diagnosis of malaria: preparation of blood smears. . Bethesda (MD): US Department of Health and Human Services, National Institutes of Health. Web.
Buttarello M. Laboratory diagnosis of anemia: are the old and new red cell parameters useful in classification and treatment, how? Int J Lab Hem 2016; 38(Suppl S1): 123-132.

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