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Acceptance Criteria for Specimens and Test Requests

Test Request (Requisition) Requirements

SAMPLE
TYPE

MAJOR

MINOR

ADDITIONAL
PREFERRED
INFORMATION
STANDARD REQUIREMENTS OTHER REQUESTED INFORMATION
CLINICAL NAME IDENTIFIER UNIQUE IDENTIFIER SAMPLE SPECIFIC
General Laboratory  

 

Patient's full first and last name

(OR coded name for confidential patients
OR temporary ID for unknown patients)

At least one (preferably two) of the following assigned identifiers (in order of priority):

1. ULI (Unique Lifetime Identifier)

2. Personal Health Insurance #, e.g. PHN

3. Government issued identification number, e.g. federal, military, RCMP, refugee, immigration, passport, etc.

4. Medical Record Number, e.g. hospital #, unique number assigned by clinic or unit, accession # or research #

- Body site and/or sample type, if applicable*
- Relevant clinical history, if applicable*
- Reason for request (for qualitative toxicology
testing)*
- Date of birth (DOB)
- Gender
- Collection date and time**
- Patient location
- Patient phone number for non-inpatients only
- Test(s) or procedure(s) ordered
- Full first and last name of requestor
- Report location or address of requestor
- Full first and last name of recipient, "copy to" recipient(s) and/or program
- Location or address of recipient, "copy to" recipient(s) and/or program
- EI Number (if applicable in outbreak situations)*

Notifiable communicable diseases as per Public Health Act**
- Infected persons full name, personal health number, date of birth, age, gender, full address, and telephone number
- The name of the disease or infecting agent
- The name of the physician who ordered the laboratory test
- The name of the reporting laboratory

- Priorty status if other than routine
- Collector ID
- Phone and/or fax number of requestor and recipient
- Physician identification number, e.g. practitioner ID
- Referral lab's accession number, if available
           

Therapeutic Drug Monitoring (TDM) Samples:
- Time of last dose
- Time of next dose
- Length of time on current dosing regimen

Transfusion Medicine:
The Transfusion Medicine requisition requires:
- Identifier (witness) ID be document when testing is for the purpose of transfusing a patient

The component/product request requires:
- Required blood component/product and volume/dosage
- Date and time of request
- Date and time of intended transfusion

Transfusion Medicine

The Transfusion Medicine requisition requires:
- Blood Bank Identification Number (BBIN) when testing is the purpose of transfusing must be recorded on the request or collection information and must correlate with the sample BBIN
- Collector name, initials or computer identification code must be documented when testing is for the purpose of transfusing the patient. Documentation of the identity of the collector on the requisition, collection tube or electronically is acceptable.


The component/product request requires:
- Special requirements and relevant clinical history

Pathology. Cytology. Microbiology, Genetics

- Exact site (e.g. laterality, lobes, quadrants, etc.), organ of origin and procedure type
- Relevant clinical history (if applicable)
- Devitalization and tissue fixation time***
- Collection date and time, if applicable***

Newborn Metabolic Screening Use name identity at time of sample collection If ULI pending (i.e. adoption, home birth) use Date of Birth - Date and time of birth
- Date and time of collection

* Refer to CLS Guide to Laboratory Services for specific or additional requirements
** Refer to the Public Health Act for additional information
*** Must appear on the sample and/or test request. When information appears on both the information must correlate. Minor test discrepancies may be corrected if correct information can be confirmed at the point of service with patient/healthcare card.

SAMPLE
TYPE

MAJOR

MINOR

ADDITIONAL
PREFERRED
INFORMATION
STANDARD REQUIREMENTS OTHER REQUESTED INFORMATION
NON CLINICAL NAME IDENTIFIER UNIQUE IDENTIFIER SAMPLE SPECIFIC

Infection Control, pharmaceutical, animal, etc.

Name of submitter

e.g. name of agency or business, or animal owner


Sample source or type

e.g. food item, animal type, drug name


Relevant history (if applicable)*
- Collection date and time
- Test or procedure ordered
- Full first and last name of requestor
- Location or address of requestor
- Full first and last name of recipient, "copy to" recipient(s) and/or program name(s)
- Location / address of recipient, "copy to" recipient(s) and/or program
- EI Number, if applicable in outbreak situations*
- Priorty status if other than routine
- Phone and/or fax number of requestor and recipient
- Physician identification number e.g. practitioner ID
- Referral lab's accession number if available
* Refer to CLS Guide to Laboratory Services for specific or additional requirements

SAMPLE
TYPE

MAJOR

MINOR

ADDITIONAL
PREFERRED
INFORMATION
STANDARD REQUIREMENTS OTHER REQUESTED INFORMATION
ENVIRONMENTAL UNIQUE IDENTIFIER SAMPLE SPECIFIC
Water, ice, or biological indicator Accession number for water or ice; access number for biological indicators, endotoxin samples As required based on type of sample submitted* As required based on type of sample*
 
* Refer to CLS Guide to Laboratory Services for specific or additional requirements