SECTION II Specimen Management Policies
and Rationale
In cooperation with selected members of the medical staff or laboratory clients, the laboratory should formulate a policy for specimen management that supports both good medicine and good laboratory practice. This policy should be documented, and a copy of it should be distributed to all users and clients of microbiology laboratory services. Part of the policy should be a carefully prepared, fact-supported manual on how to collect and handle specimens. It is important for nurses and clinicians to understand the needs of the laboratory regarding specimen collection and handling. In addition, the policy should address the special needs of the laboratory and the rationale for these needs. Laboratory leaders should be prepared to provide in-service training on specimen collection and management policies to medical and nursing staff and others who collect specimens for microbiology. This section discusses simple policy statements and includes the rationale for each policy in italics.
Collection Times
Include the time of specimen collection on the requisition. Without it, one may not be able to interpret results.
Patricia Charache, Ph.D., (D)ABMM
(Deceased)
1.The optimal times for specimen collection must be based on both the type of infectious disease process and the ability of the laboratory to process samples. Laboratories are usually better staffed and therefore better able to receive and process specimens during the daytime hours.
The microbiology laboratory may not be well staffed during evening and late-night hours.
Samples collected late in the evening often do not produce adequate growth by the next morning. However, provisions must be made to handle and report urgent specimens during “off” hours, and consultation with supervisory personnel is highly recommended.
2.Twenty-four-hour specimen collections for culture should be discouraged, and such collections should be accepted only after consultation with the microbiologist or pathologist.
Pathogens that appear at their highest concentration in first morning secretions will be diluted by added material.
Stored samples are very likely to be overgrown with contaminants. Improved laboratory culture techniques preclude the need for large volumes of samples.
3.First early-morning sputum and urine samples are optimal for recovery of acid-fast bacteria, fun
