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Specimen Management Manual

Digital Healthcare Program July 2016

1

Contents

Placing Orders ................................................................................................... 3

Add On Orders ................................................................................................... 6

Ordering Miscellaneous Pathology .................................................................... 7

Ordering Multiple Instances of the Same Specimen .......................................... 8

Adding Orders to Your Favourites Folder ........................................................ 10

Viewing Detailed Order Information ............................................................... 12

Pathology Order Status Definitions .................................................................. 14

Cancel / Reorder or Cancel / Discontinue an Order ......................................... 15

Customising the Orders Screen ....................................................................... 17

Printing a Requisition Form for Outpatient Specimen Collection ..................... 19

Specimen Collection – Quick Guide ................................................................. 20

Specimen Collection – Detailed ....................................................................... 21

Inpatient Specimen Collection Runs ................................................................ 25

Specimen Label Reprint ................................................................................... 27

Microbiology Ordering Guide ........................................................................... 29

Serology Ordering Guide .................................................................................. 33

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Type the order you require in the search field

Placing Orders

The Orders section of the Patient Medical Record allows

electronic requests to be made for radiology, pathology,

patient care tasks and inpatient consults

How to place an order

1. Open the patient’s medical record and select theappropriate encounter

2. Select Orders from the Patient Menu

3. The Orders profile page will display

4. Click the Add icon in the top left of the Orders profile page

OR

5. Click Add in the patient Menu next to Orders

6. Enter the name of the required order (e.g. Consult toPhysiotherapy, Vital Signs) into the search field thenpress enter

Please note: The only consults available for order

at The Townsville Hospital are inpatient consults

for Physiotherapy, Dietetics, Speech Therapy,

Occupational Therapy and Social Work.

Receiving department also requires a phone call.

All other referrals (incl outpatient referrals) are to remain as per current general business processes.

7. Select the correct order by single clicking on the title

from the list that populates in the window below. Theorder will highlight in blue when it has beenselected

8. You may have to change the search criteria betweenStarts with and Contains to assist you in locating thecorrect order

9. Follow the previous steps to search for more orders

10. Click Done to return to the Orders forSignature window when you have selected all relevantorders

11. Select the order, then enter details into the Detailswindow

12. To remove an order from the Orders for Signaturewindow, right click on the order and select Remove

13. Click Sign when finished, enter your

password and click OK

14. You will have to refresh the screen for the order to

update from Processing to Ordered.

Always check the Orders section of the patient’s chart before placing orders to avoid duplicates.

The Contains search requires at least 3 characters to search, the Starts with search only requires 2.

If you have multiple orders in the same category (eg Patient Care), to modify multiple Details about these orders, hold down Ctrl on your keyboard and use the left mouse click to highlight multiple items. When you enter the information in the Details window, this information will update all the orders selected

A white cross in a blue circle icon indicates that mandatory order details are not complete for that order.

Select the correct order

Click the drop down box to

change search criteria between

Starts with and Contains

3

How to place Pathology orders

1. Follow steps 1-7 in how to place an order. You can search by the pneumonic or description of the test, e.g. FBC or full blood count.

Transfusions and Cross-match requests will remain on paper.

2. The Ordering Physician may appear for orders placed by Nurses or Allied Health staff as they may require co-sign. The Ordering Physician window will appear with a mandatory yellow field to enter the Physician Name, click OK once you have searched for the correct clinician and selected the appropriate Communication Type.

The Communication Type refers to the method of communication for the order. If results are applicable to the order, they will return to the ordering clinician and nominated physician.

You should only place orders that are within your scope of practice

Selecting Phone or Verbal (co-sign) will send a message to the selected ordering physician to notify them of the order(s).

Selecting Written (no co-sign) will not send a notification to the ordering physician.

A selection of Protocol means that ordering these tests is within your approved scope of practice and a Unit Based Protocol supports this order.

3. Follow the previous steps to search for more orders

4. Click Done to return to the Orders for Signature window when you have selected all relevant orders

5. Complete the order details:

Enter order information in Reason for order/details. This will be printed on the requisition form. Use this field to convey any order or clinical details.

Check the Requested collection time. Specimen collection orders are valid for 366 days. Generally, specimen collection orders are collected in the Collection Details screen. However, 15 days after the order date the specimen collection details are no longer viewable in the Collection Details screen.

If the specimen will be collected as an outpatient, forward date the Requested collection time to past the anticipated date of collection.

Ensure correct Specimen type and Body site if appropriate

If the specimen is to be collected by a nurse or Doctor, click Yes for Clinician collect. If the specimen is to be collected by a phlebotomist, click No.

Inpatient pathology orders placed on ieMR will not require a paper requisition form to accompany the specimen/s. For patient’s requiring internal or external outpatient collection, a requisition form must be printed from the system to give to the patient.

Once the ordering physician’s name has been entered, the system will automatically populate the Ordering Physician window again. It assumes the same physician, previously entered, has requested the next order requiring co-sign. Once you have closed down the patient’s chart, this will reset. To select a different ordering physician, click Done, right click on the order and select Ordering Physician.

Doctor/Nurse to collect

Phlebotomist to collect

4

Select Routine or Urgent in the Collection Priority field if the sample is for Clinician collect. The order will be ready to collect once the order is signed.

If the sample is for inpatient Phlebotomy collection, selecting Routine in the Collection Priority field will schedule the specimen to be collected on the next Phlebotomist round. Selecting Priority AM/PM or Routine AM/PM will schedule collection at the set AM/PM Phlebotomist rounds.

There are a number of inpatient AM collections runs with Individual wards have different collection run times (please check with ward for allocated times). The PM collections runs are 12.00pm. Ensure the order is placed at least 15 minutes before the designated run.

The order will be available for collection immediately in the Collection Details window when selecting Urgent in Collection priority even if it is designated for phlebotomy collect.

Ensure the Collected field is always set to No, unless you are placing an Add On order. This ensures that you are able to print off specimen labels.

If you have selected Collected: Yes and have not printed off labels after signing the order, refer to the QRG on reprinting labels

6. Continue to fill out other relevant information including Requestor Provider Number, Requestor contact/phone pager, Fasting Status, Patient Status, and Copy doctor name and address.

7. To communicate additional information to the lab, use the Order Comments tab.

Any details entered in the Order Comments tab will not be printed on the paper requisition form.

8. Click Sign , enter your password and then click OK to finalise the order/s.

How to enter a different Ordering Physician

To enter a different Ordering Physician:

1. Follow the first 9 steps in How to Place an Order and you will return to the Orders for Signature window

2. Right click on the order which requires the Ordering Physician to be altered

3. Select Ordering Physician

4. The Ordering Physician window will appear

5. Enter the correct physician name and click OK. If results are applicable to the order, they will return to the Message Centre of the nominated Ordering Physician and the clinician who placed the order.

Generates Add On

order

Clinician Collect: No - will place the order on the selected scheduled run.

Clinician Collect: Yes - the order will be available for collection in the

Specimen Collection window after signing.

Urgent orders will be available for

collection immediately regardless

of the clinician collect status

5

Add On Orders

If you have already placed an order for Pathology you can order an Add On pathology request to an already collected sample. This prevents placing a new order and having more blood or samples taken from your patient.

How To Add On To An Existing Pathology Sample

Call the Pathology Lab to first confirm they have enough sample remaining to run an additional test on it.

1. While in the patient’s chart, select Orders from the patient Menu. The Orders profile page will display.

2. Click the Add icon in the top left of the Orders profile page.

Or, click Add in the patient Menu next to Orders.

3. Enter the name of the order into the search field, press enter and select the pathology order you would like to add on to an already collected sample.

4. Click Done when you’ve finished adding orders. Click on the order, then in the Details section select Add On from the *Collection Priority field.

5. In the Reason for order/details: field you can add any additional information.

6. Select Yes in the *Collected field.

7. Complete any other details that may be required and

click Sign to finalise your Add On order.

8. The Add On order will now be sent to Pathology to be processed. The order will show as Ordered (Collected) in the orders screen.

An Add On order will not show in the Specimen

Collection window because a new sample does not need to be collected from your patient.

9. If you have clicked Collected: No in the details screen, you will receive this pop up when clicking Sign. You will need to follow steps 1-9 to place the order, and ensure to click Collected: Yes in the order details.

6

Ordering Miscellaneous Pathology

If you cannot find a pathology order or are unsure of the order name to search for, you should call Pathology for advice. Alternatively you can place the order using the Miscellaneous Pathology order.

1. While in the Orders section of the patient’s chart, Click

the +Add icon in the top left of the Orders profile

page. Or, click +Add in the patient Menu next to Orders.

2. Enter PMISC into the search field and select the order by

single clicking

3. Click Done to return to the Orders for

Signature window

4. Click on the PMISC order and complete the mandatory fields in the Details for Miscellaneous Pathology Test (PMISC) section in the Order for Signature Window, which are the yellow fields.

Be as specific as possible. The requested test will be transmitted to the pathology exactly as typed in the Misc test name field, specifying type of test (e.g. level, screen, quantitation, PCR etc.), this will ensure the appropriate test is performed.

If multiple miscellaneous tests are required on the same order, enter all tests separated by a comma (e.g. CGH Array, Charcot Marie Tooth gene analysis)

4. Specify the Specimen Type e.g. Blood, Aspirate, Fine needle aspirate

5. Name the test in the Misc Test Name field e.g. Charcot Marie Tooth gene analysis

6. Enter any further details into Reason for order/details

7. Complete any other fields as appropriate

8. Click Sign , enter your password and then click OK to finalise the order.

Mandatory

fields

7

Ordering Multiple Instances of the

Same Specimen

There are two options to order multiple specimen collections, for example multiple histopathologies or microbiologies.

Option 1: Using Order Comments

1. In the Orders section of the patient’s chart click the

icon

2. Enter the name of the order eg histopathology.

3. Select the correct order from the list that populates in the window below. Click the order once.

4. Click Done to return to the Orders for Signature window

5. Click on the order and enter the order details in Details

6. Click the Order Comments tab

7. Type the name of each sample into the Order Comments field using a 1/4, 2/4, 3/4, 4/4 numbering sequence. These details will be sent to the lab.

Any details entered in the Order Comments tab will not be printed on the paper requisition form.

8. Sign the order by clicking Sign, enter your password and click OK.

To print the labels refer to the relevant QRG. When a clinician takes multiple samples for a single biopsy, only one of the specimen containers needs a specimen label printed from the Specimen Collection screen. The remaining specimen containers can be labelled using the specimen label printed out multiple times, hand labelled, or using the patient identification label. All specimens must be numbered 1/4, 2/4, 3/4, 4/4 etc. as corresponding to the Order Comments details.

Search for order

Modify the search criteria

as necessary

Click the order name

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Option 2: Ordering Multiple Instances

1. Follow steps 1-3. Click the name of the order as many times as specimens you will collect eg for 4 x swab sites, you would place 4 x Swab Superficial Sites Culture (M/C/S) orders

2. Click Done to return to the Orders window

3. Select the order and enter the order details in the Order Entry Fields as appropriate in the Details tab.

4. To avoid a Duplicate Order Error, each order for the same test must be given a different Requested collection time e.g. Sample 1 1500, Sample 2 1501. Adjust the time using the up and down arrows.

5. Click Sign to finalise the order. Enter your password and then click OK.

6. If different collection times are not entered, the Duplicate Order Alert window will display. Select Cancel to return to the order details screen and just the times. Once all of the correct details have been entered, click Sign, enter your password and click OK.

If you have multiple orders in the same category (eg Laboratory) to modify multiple Details about these orders, hold down Ctrl on your keyboard and use the left mouse click to highlight multiple items. When you enter the information in the Details window, this information will update all the orders selected.

To print the labels refer to the QRG. Ensure the correct label is attached to the correct specimen.

9

Adding Orders to your Favourites

Folder

Favourite orders can be added to a Favourites folder. Orders added as favourites are saved to your individual login.

Building a Favourites Folder for Orders

1. Open the patient’s medical record

2. Select the Orders Tab in the Patient Menu


icon

4. Search for the relevant order in the search field

5. Right-click on the order

6. Select Add to Favourites

7. The Add Favourite window will open

8. Select the relevant folder and click OK to add it to that folder. You can also create a new folder within Favourites by clicking New Folder, then renaming the folder to suit your needs (e.g. Septic screen) and then click OK.

9. Add more orders by repeating steps 1 to 8

How to add orders with details to the Favourites Folder

Another feature of order favourites is the ability to save favourite orders with pre-filled or pre-set details. This saves entering details such as Provider number or contact phone number each time commonly used orders are placed.

1. Open the patient’s medical record

2. Select the Orders Tab in the Patient Menu


icon

4. Search for the order and then click on the appropriate order

5. Click Done

6. Complete the order details as appropriate- refer to the relevant quick reference guide.

7. Right click on the order and select Add to Favourites

8. The Add Favourite window will open

9. Select the folder and click OK to add it to that folder. You can also create a new folder within Favourites by clicking New Folder, then renaming the folder to suit your needs (e.g. Septic screen) and then click OK.

Locating Favourites Folder in Orders

1. Select the Orders section in the Patient Menu

2. Click the Add icon in the top left of the Orders screen

3. You will be presented with the Add Order window

4. Click the star (Favourites) icon

5. This will open the Favourites folder and any newly created sub-folders

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10. Click on the folder, e.g. Septic Screen, and open to view the orders available

11. To place an order in your favourites folder, click on it as you would if you had searched for that order

12. Click Done to return to the Orders window

13. Complete order details as appropriate. Refer to the relevant quick reference guide on ordering for more information.

14. Click Sign, enter your password and click OK when finished to place the order/s

When favourites are created they will be saved and available only against the encounter they were created in. Favourites will need to be created for both inpatient and outpatient encounters.

11

Viewing Detailed Order Information

Order information and details are viewable in the Orders section of the Patient Menu. From the Orders screen you can view information about who placed the order, the details of the order, and any modifications or changes made to an order. This feature also allows you to view the Accession number for orders to reprint specimen labels if required.

Viewing Order Information

1. Enter the patient’s medical record

2. Click on the Orders section of the Patient Menu

3. The Orders screen displays order information

4. You can view more detailed order information by single clicking on the blue text of the relevant order

OR

5. Right-click on the relevant order and select Order Information

6. The Order Information window will open

7. Displayed at the top of the window is information of the ordering clinician and the date and time it was placed. Use the tabs across the top to view information regarding the order. Click on a tab to view the details.

Content of Order Tabs

Tab Name Information Displayed

Details

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Additional Info

Comments Additional comments added into the comments tab

Validation Displays information regarding any co-sign validation of a student placed order

History

Also displays details of any modifications made to the order including discontinued and cancelled orders

Results Displays related results for the order once they are available, for example Pathology orders

Ingredients Displays the components of a special medication order

13

Pathology Order Status Definitions

You can view the progress of orders placed for Pathology in the Orders section of the patient’s chart. As the sample is being processed the Status column updates what is displayed as the order goes through each stage of processing.



3. The Orders screen displays order information

Status Definitions

Status Displayed

Definition

Processing Displays after an order has been placed but the orders window has not been refreshed.

Ordered (Scheduled)

The Pathology order has been ordered and is scheduled for collection on the designated phlebotomy run.

Ordered (Dispatched)

The Pathology order has been placed and is ready for collection.

Ordered (Collected)

The sample for that order has been taken from the patient and processed through the Specimen Collection window. This status will also display if an Add on order is placed.

Ordered (In lab)

The sample has been received by Pathology and is waiting to be processed.

Ordered (Preliminary)

Testing has been performed but not yet complete or validated.

Completed The sample has finished processing and results are available for viewing.

Cancelled/ Discontinued

Testing has been cancelled or discontinued.

Reasons for the lab cancelling an order include:

Pathology Amended Order

Clinician Requested Cancel

Pathology NOTEST

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Cancel, Reorder or Discontinue an

Order

Once signed, you can choose to Cancel/Reorder or Cancel/Discontinue an order.

How to Cancel/Reorder or Cancel/Discontinue an Order



3. Right-click on the relevant order

4. To modify or cancel the incorrectly placed order select Cancel/Reorder or Cancel/Discontinue

5. The Details window will open

6. Modify the details of the replacement order if Cancel/Reorder was selected

7. Click Orders For Signature

8. Click Sign

9. You will be prompted to select a Discontinue reason for the cancelled order

10. Click First Detail

11. Select a Discontinue reason then click Sign

12. Enter your Password and click OK

13. The original order will now display as Discontinued and the new order (if made) will display as Ordered

14. To view more detailed information about the order cancellation single click on the blue text of the relevant order

OR

15. Right-click on the relevant order and select Order Information

Remember to notify the appropriate department or clinician/s regarding the order cancellation as well as the details of the reorder if required. If you want to Cancel a pathology order which has been collected, you will have to notify the lab.

15

16. The Order Information window will open

17. Click the History tab at the top to view detailed information regarding the order and the Discontinue Reason

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Customising the Orders Screen

You can customise what orders are displayed in the Orders screen using the filter function. This can help categorise information displayed and find previous orders placed.

Customising the Orders screen

1. Click on the Orders section in the menu of the patient’s medical record

2. The default display setting in Orders is All Active Orders, All Inactive Orders, All Orders 5 Day Back

3. To filter the Orders window click the filter banner at the

top of the window . The Advanced Filters window will display.

4. You can quick select desired display options from the Display: list.

5. You can additionally custom filter order statuses in the

section below the Display: filter, check the boxes to view/hide information in Orders.

6. You can create your own custom display filter by clicking

New , naming your new filter in the Display: option and then selecting your desired filter options. Or just start selecting filter options then click Save As

to save and create your new display filter.

7. Once you’ve selected your filter preferences click Apply

to activate those settings in the Orders screen.

8. Your filter options will display in the filter banner at the top of the Orders window.

9. In the View window to the left you can quick select the order types you’d like displayed in the Orders window.

10. You can also condense/expand the Order Type sections

in the Orders window by clicking the icon next to the heading.

Check/uncheck these boxes to change order types

displayed in the Orders window to the right

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Customising Columns

You can also customise the information columns in the Orders window as well.

1. Right click in the Orders window and select Customise View…

2. The Customise View window will display. Select options from the Available columns section, click Add, and use

the next to the *Selected columns section to change the order of the columns in the Orders window.

3. You can also group displayed orders by selecting from available categories at the bottom of the Customize View window. You can also group them in ascending or

descending order. Click OK when done to apply the settings to the Orders window.

Your selected filter options will stay customised to your ieMR login. You will not need to re-specify your display filters each time you log in.

18

Printing a Requisition Form for

Outpatient Specimen Collection

If the patient will have specimens collected as an outpatient, it is imperative to print and provide the requisition form to the patient. This ensures all tests are performed, allows the collector to identify the encounter the order was placed on, and enables patients to seek pathology internally and externally.

1. Click on the Orders section in the menu of the patient’s medical record

2. Locate order/s. Select multiple orders by holding down the Ctrl button on the keyboard and using the left mouse button to click.

3. Right click on the order/s and selected Print and then Reprint Requisition…

If you have ordered multiple orders in the same ordering session (you have signed off all the orders at the same time), and you select one order and print the requisition form, all orders ordered in that session will display on the form.

4. The Select Printer Options will display. Select the closest printer and select OK. The window will remember the last printer used.

To select multiple orders to print, hold down Ctrl on your keyboard and use the left mouse click to highlight multiple items.

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Specimen Collection – Quick Guide

Specimen Collection uses positive patient identification checks and scanning to record collection and print labels in PowerChart. The Specimen Collection window can be launched within a patient’s chart. The Specimen Collection button appears in the ieMR toolbar.

Refer to site specific guidance and procedures for specimen collection.

Collecting a specimen

To collect a specimen for a patient:

1. Open the patient chart in the appropriate encounter the specimens were ordered.

2. Click Specimen Collection from the ieMR toolbar

3. The Collection Details window will open. Confirm the patient’s identity.

4. Scan the patient’s wristband using the barcode scanner

OR

5. Click on if a wristband is not available

6. The Collection Details window will open and display a list of orders available for collection in the selected encounter

Suggested pathology specimen containers will be displayed under the test/s name. These may need to be cross referenced with your hospital policy.

Do not select Not Collected, as this will cancel the order, or Reschedule.

7. Hover the mouse over the name of the specimen to view a text box with details of the collection

8. To print out specimen labels, click on the Print drop down arrow

9. Select Print All Labels. The Print Labels window will open. The Select All check box will be selected as a default. All specimens will have the corresponding checkbox ticked.

10. Select required specimen labels for printing

11. Select the printer.

12. Click the Print button

13. The label/s will print to the selected printer.

14. Once the specimens are in their containers, initial and time and date the label/s. Affix the appropriate label to the correct collection container. The barcode must be horizontal and straight, and over the existing tube label.

15. To communicate if the patient is fasting

or if the specimen is urgent/critical

, use the appropriate stickers and attach to the lid of the specimen. Write any additional comments relating to the collection on the specimen label or on a note placed in the specimen bag with the container.

16. Use the barcode scanner to scan the labels attached to the specimen containers. The system will confirm that the patient chart and the specimen container label are matched to the correct patient. The specimen order will be displayed with a tick to indicate it has been collected.

17. If a barcode scanner is not available it will be necessary to manually change the collected status from the Specimen Collection window. Hover the mouse over the specimen

collected, the line will highlight and the Status menu will be available.

18. Click on to the right of the specimen order

19. A menu will be displayed. Select Collected.

20. A warning message will display as the label was not scanned. Click Yes if you have verified the container and label.

21. Click to certify you have collected the correct samples from the correct patient and labelled each container appropriately. The status of the specimen will automatically change to Ordered (Collected) in PowerChart and will drop off the Specimen Collection window. Marking the samples as Collected will create an entry in AUSLAB for the tests indicated on the label.

22. Click Close to close the Specimen Collection window.

Refresh Filter icon

Print icon Indicates priority or urgent collection

20

Specimen Collection - Detailed

Suggested pathology specimen containers will be displayed under the test /s name. These may need to be cross referenced with your hospital policy

Specimen Collection uses positive patient identification checks and scanning to record collection and print labels in PowerChart. The Specimen Collection window can be launched within a patient’s chart. The Specimen Collection button appears in the ieMR toolbar.

Refer to site specific guidance and procedures for specimen collection.

Collecting a specimen

To collect a specimen for a patient:

1. Open the patient chart in the appropriate encounter the specimens were ordered.

2. Click Specimen Collection from the ieMR toolbar

3. The Collection Details window will open. Confirm the patient’s identity.

4. Scan the patient’s wristband using the barcode scanner

OR

5. Click on if a wristband is not available

6. The Collection Details window will open and display a list of orders available for collection in the selected encounter

Do not select Not Collected, as this will cancel the order, or Reschedule.

Filters can be applied to the Collection Details window to determine what collection details display for a user.

7. To apply filters to the Collection Details page click on the

Filter Collections icon. The Filter page will open.

8. Select the required Collection Type radio button.

Lab Collect will display only those collection types that are designated to a phlebotomist to collect

Nurse Collect will display only those collection types designated for clinician collect

Both will display all orders currently due for collection

9. Click on the Show Nurse Collect Indicator checkbox. This will display a Nurse Collect text indicator on the list of collection details against the specimen requiring a nurse collect.

10. Tick the required Specimen Type check boxes.

11. The Save as Default checkbox can be used to apply the filter preferences across all patient records.

12. Click Apply

13. The Specimen Collection screen will display reflecting the chosen filters.

14. Hover the mouse over the name of the specimen to view a text box with details of the collection

Refresh Filter icon

Print icon Indicates priority or urgent collection

Nurse Collect indicator

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15. If you are unable to locate the specimen you are collecting in the Specimen Collection window, check the following:

You are in the correct patient

You are in the encounter the order was generated

The filter options in Specimen Collection are set to Collection Type: Both

The order status for the specimen displays as Ordered (Dispatched) in the Orders section of the patient’s chart. If the order was placed and the Collected option was set to Yes, you will have to use label reprint to print labels. Refer to the appropriate QRG. If the order status is Ordered (Scheduled), it will not be available in the Specimen Collection screen until the designated phlebotomy run. If you need to collect the specimen earlier, the original order must be reordered with the appropriate details. Contact the appropriate clinician if required. If the order status displays as Ordered (Discontinued) or (Collected), contact the relevant clinician.

The order is more than 15 days after the Requested collection date/time. To collect the specimen, use the label reprint option, refer to the relevant quick reference guide. You will not be able to mark the order as collected.

Printing the specimen labels from Specimen Collection

1. To print out specimen labels, click on the Print drop down arrow

2. Select Print All Labels. The Print Labels window will open. The Select All check box will be selected as a default. All specimens will have the corresponding checkbox ticked.

3. To select required specimen labels for printing, deselect the Select All check box

4. Tick the required checkboxes against the individual specimen labels

5. Select the printer. You can also set a default printer by checking the Set as default label printer check box.

6. Click the Print button

7. The label/s will print to the selected printer.

8. Once the specimens are in their containers, initial and time and date the label/s. Affix the appropriate label to the correct collection container. The barcode must be horizontal and straight, and over the existing tube label.

For paediatric or smaller containers, the label should be attached using the MicroTube Clear Tab to ensure the barcode remains visible.

9. To communicate if the patient is fasting

or if the specimen is urgent/critical , use the appropriate stickers and attach to the lid of the specimen.

It is essential that notation labels are affixed only to the lid of the specimen. The only labels to be affixed to the specimen are the specimen label and a critical/urgent label if there is no room on the lid of the container. Too many labels on the tube may interfere with the processing of the specimen.

10. Use the barcode scanner to scan the labels attached to the specimen containers. The system will confirm that the patient chart and the specimen container label are

22

matched to the correct patient. The specimen order will be displayed with a tick to indicate it has been collected.

11. If a barcode scanner is not available it will be necessary to manually change the collected status from the Specimen Collection window. Hover the mouse over the specimen

collected, the line will highlight and the Status menu will be available.

12. Click on to the right of the specimen order

13. A menu will be displayed. Select Collected.

14. A warning message will display if the label was not scanned. Click Yes if you have verified the container and label.

Do not use the Add comment option in the menu. This will not be sent to the lab. If you need to let the lab know any information, write it on the specimen label or attach a note and place in the specimen bag.

15. Click to certify you have collected the correct samples from the correct patient and labelled each container appropriately. The status of the specimen will automatically change to Ordered (Collected) in PowerChart and will drop off the Specimen Collection window. Marking the samples as Collected will create an entry in AUSLAB for the tests indicated on the label.

16. Click Close to close the Specimen Collection window.

Collecting more or less containers than recommended in the Specimen Collection screen

If you need to collect less containers than suggested in the Specimen Collection screen, print all labels of specimens collected and mark the relevant specimens as collected. Place the spare labels in the bag to be sent to the lab. If you need to collect more containers than suggested in the Specimen Collection screen, print the required number of specimen

labels and affix them to the containers. Mark the extra container/s as SPARE and cross out the barcode.

Accidentally marking the wrong order as collected

If you accidentally marked the wrong order as collected in the

Specimen Collection screen, and have not clicked yet,

hover over the order, click and select Reset.

If you have marked the order as collected and clicked

, you will need to contact the ordering physician and notify the lab the specimen has not been collected. The ordering clinician will need to locate the original order, right click and select Cancel/Reorder, fill out the appropriate details and sign the order.

Difficult collection or unable to collect

If you want pathology to attempt to perform testing on the specimens you were able to collect, mark or scan these specimens as Collected. Collection notations (difficult bleed, syringe collection etc.) can be noted by writing on the label or on a note placed in the specimen bag.

If the collection order cannot fully be completed at the current time and it has been determined that the collection will be re-attempted at another time, scan the specimens that have been collected, but do not scan the uncollected labels. The specimen should remain the Specimen Collection

screen. Do not use the button as this will cancel the order. No entry for the tests will have been created in AUSLAB and the laboratory will not attempt to perform the tests.

Collecting a Miscellaneous Order

1. If you open up the Collection Details window and the specimen for collection is a Miscellaneous Pathology Test (PMISC), you will need to view the order details before collection. Do not contact the Lab

Notify relevant clinicians and complete relevant documentation when unable to collect.

23

Close down the Collection Details window

2. While in the patient’s chart navigate to the Orders

section

3. Locate the Miscellaneous Pathology Test (PMISC) in the Orders screen, right click and select Order Information

4. In the Details tab it will display the Misc. test name

5. Return to the Collection Details window to collect the

specimen using the appropriate container.

24

Inpatient Specimen Collection Runs

Collection Navigator pane

Click to collapse or to expand the Collection Navigator pane.

The Collection Navigator pane displays:

Patients Name: Double click to open the Patient Medical Record

Manage View hyperlink: Click to return to the Manage View screen to modify locations selected

Location list: Click to expand list details, click

to collapse list details. Click on collection location to toggle between lists.

Collection priority status, if applicable

Patient details window

This window displays:

Patient name

Pathology requested, including request date and time

Collection priority status

Chart Collections Hyperlink

Collecting specimens

1. Click the hyperlink, the Collections Details window will open

Refer to the QRG Specimen Collection for further information

Specimen collection orders are valid for 366 days. Generally, specimen collection orders are collected in the Collection Details screen. However, 15 days after the requested collection date and time, the specimen collection details are no longer viewable in the Specimen Collection screen. To complete specimen collection after this 15 day window period or to reprint a label, you will need to complete the Label Reprint process.

Specimen Collection – Label Reprint

1. Click on the ieMR Toolbar options drop down menu

Collapsed view of

Location list

Manage View

hyperlink

Expanded view

of Location List

Indicates

priority or

urgent

Patient Name and

details. Hyperlinks to

medical record.

Pathology request

details, including

priority status

Chart

Collections

hyperlink

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2. Select Label Reprint

3. The PathNet Collections: Label Reprint window will open

4. Scan the accession barcode on the paper pathology requisition form if available

5. The Accession details will now display. Confirm the details are correct.

6. If you do not have a barcode scanner, manually enter the Accession number that appears on the label.

Multiple orders placed in the same ordering session will share the same Accession Number. Using the Label Reprint feature, you will only need to use that single, shared Accession Number to print all the specimen labels for that set of orders.

Do not change the Ending Accession number as you may print out the incorrect label. If you have multiple accession numbers, enter and print them individually using the Starting Accession field

7. Select the correct printer from the Label Printer drop down menu

8. Click Print

9. The specimen labels will print

10. Complete steps for blood collection. Refer to the relevant QRG for more information.

Accession number

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Specimen Label Reprint

Specimen collection orders are valid for 366 days. Generally, specimen collection orders are collected in the Collection Details screen. However, 15 days after the requested collection date and time, the specimen collection details are no longer viewable in the Specimen Collection screen. To complete specimen collection after this 15 day window period or to reprint a label, you will need to complete the Label Reprint process.

Specimen Collection – Label Reprint

1. Click on the ieMR Toolbar options drop down menu

2. Select Label Reprint

3. The PathNet Collections: Label Reprint window will open

4. Scan the accession barcode on the paper pathologyrequisition form if available

5. The Accession details will now display. Confirm thedetails are correct.

6. If you do not have a barcode scanner, manually enter theAccession number that appears on the label.

Multiple orders placed in the same ordering session will share the same Accession Number. Using the Label Reprint feature, you will only need to use that single, shared Accession Number to print all the specimen labels for that set of orders.

Do not change the Ending Accession number as you may print out the incorrect label. If you have multiple accession numbers, enter and print them individually using the Starting Accession field

7. Select the correct printer from the Label Printer dropdown menu

8. Click Print

9. The specimen labels will print

10. Complete steps for blood collection. Refer to therelevant QRG for more information.

Locating the Accession Details in the Patient’s Chart

The Accession details are also viewable in the Orders section of the patient’s chart. You may need to access the accession details for an order if:

You accidentally mark the specimens as being collected and click the Sign button prior to printing the specimen labels.

Accession number

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You mark the specimens as collected and click Sign, but then need to reprint the labels, e.g. the labels get ripped or damaged

To locate the pathology Accession number:

1. Click on the Orders section in the Patient Menu while inthe relevant patient’s chart

2. Right-click on the relevant order/s

3. Select Order Information

4. The Order Details window will open

5. Click on the Additional Info tab to view the Accessionnumber

6. Write down the Accession number displayed

7. Click to close the window

8. Follow steps 1 to 10 above to complete a Label Reprint.

9. At step 4, manually type in the Accession number intothe Starting Accession field

Right click

Select Order

Information

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Microbiology Ordering Guide

Specimen Comments Test code in ieMR Notes

Pus: superficial sample

(e.g. swab from ulcer, wound etc)

Superficial Pus or Swab Culture (M/C/S)

Information on nature and siteof lesion is essential for correctlaboratory interpretation ofresults

Pus: deep/invasive sample

(e.g. swab or purulent material collected from incised abscess/collection or intraoperatively)

Deep Invasive Pus or Swab Culture (M/C/S)

If acid fast bacilli examination(test code: Acid Fast Bacilli(M/C/S) or fungal culture (testcode: Fungal Culture (M/C/S)required, add onto the samespecimen

Tissue sample

(e.g. biopsy of any tissue)

Tissue Culture (M/C/S) Information on nature and siteof tissue is essential for correctlaboratory interpretation ofresults

If acid fast bacilli examination(test code: Acid Fast Bacilli(M/C/S)) or fungal culture (testcode: Fungal Culture (M/C/S)required, add onto the samespecimen

Tissue sample

(Gastric biopsy: for Helicobacter pylori Urease Test)

CLOtest Rapid Urease Test slide

HUT Helicobacter pylori Urease

Fluid sample: from normally sterile site

(e.g. pleural, pericardial, ascitic, peritoneal dialysis, synovial fluids)

Fluid collected in sterile container only

Sterile Fluid Culture (M/C/S)

Information on nature and siteof fluid is essential for correctlaboratory interpretation ofresults

Invasively collected eye fluids(e.g. vitreous or aqueous fluids)should use the Eye InvasiveCulture (M/C/S) test code

Drain fluid/other normally non-sterile site fluids should use theDrain Fluid Culture (M/C/S) testcode

If synovial crystal examination(test code: Fluid Synovial Crystalsis required, add onto the samespecimen (but note cannot beperformed if specimen onlycollected in blood culture media

Fluid collected in sterile container and in blood culture media

Sterile Fluid Specimen together with Fluid in Blood Culture Medium (M/C/S)

Fluid collected in blood culture media only

Sterile Fluid in Blood Culture Medium Only (M/C/S)

Fluid sample: from drain/other normally non-sterile site

Drain Fluid Culture (M/C/S)

Drain fluid results may bemisleading; direct collection of arepresentative specimen inpreferable

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Urine sample

(e.g. midstream, indwelling catheter etc)

Urine Culture (M/C/S) Information on mode of collection(i.e. midstream, catheter, clean catch etc) is essential for result interpretation

Sputum sample

(e.g. expectorated or induced)

Respiratory Sputum or ETT Culture (M/C/S)

If acid fast bacilli examination (test code: Acid Fast Bacilli (M/C/S)) or fungal culture (test code: Fungal Culture (M/C/S)) required, add onto the same specimen

If GeneXpert (NAAT) test for MTB is required please order: Miscellaneous Pathology Test (PMISC), enter details of test and add onto the same specimen

If Pneumocystis PCR (test code: Pneumocystis jiroveci PCR) is required add onto the same specimen (but note will only be performed on induced sputum)

Bronchoscopically-collected respiratory tract sample

Respiratory Bronchoscopic Collection Culture (M/C/S)

If acid fast bacilli examination (test code: Acid Fast Bacilli (M/C/S)) or fungal culture (test code: Fungal Culture (M/C/S)) required, add onto the same specimen

If Pneumocystis PCR (test code: Pneumocystis jiroveci PCR) is required add onto the same specimen

If Respiratory virus PCR (test code: Respiratory Virus PCR) is required add onto the same specimen

Nasopharyngeal swab/aspirate

Full respiratory virus PCR panel

Respiratory Virus PCR Respiratory Syncytial Virus Direct Antigen: performed on Paediatric NPA, then referred for full PCR panel

Faeces sample Bacterial pathogens

Faeces Bacterial PCR

If microscopy for faeces erythrocytes and leukocytes required (test code: Faeces Microscopy (RBC,WBC) Only), add onto the same specimen

Additional information will be required for microscopy for intestinal helminths before testing will be performed: access the specific request form by typing “helminths microscopy”: into QHEPS search field

Clostridium difficile

Faeces Clostridium difficile Screen

Viral pathogens

Faeces Viral PCR

Protozoal pathogens

Faeces Protozoan PCR or

Faeces OCP PCR

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Intestinal helminths Faeces Helminth Microscopic Examination

Blood culture sample Standard blood culture Blood Culture (M/C/S) If collected from PICC line: Enter information in ‘Order Comments’

Mycobacterial blood culture requires specialised blood culture media: contact laboratory

Blood culture for mycobacteria

AFB Blood Culture

CSF sample CSF Culture (M/C/S) If other tests required, add onto the same specimen; e.g. India Ink (test code: India Ink Stain for Cryptococcus microscopy), Cryptococcal antigen (test code: Cryptococcal Antigen), fungal culture (test code: Fungal Culture (M/C/S)), bacterial/viral PCRs (test codes: Enterovirus PCR, HSV Type 1 PCR, HSV Type 2 PCR, Neisseria meningitidis PCR, Streptococcus pneumoniae PCR etc), acid fast bacilli examination (test code: Acid Fast Bacilli (M/C/S))

For suspected subarachnoid haemorrhage, use test code CSF Subarachnoid Culture (M/C/S)

Swab: superficial sample from ear, nose, throat, or conjunctiva

Ear, Nose, Throat and Conjunctival Swab Culture (M/C/S)

Do not use Eye Invasive Culture (M/C/S) test code unless invasively-collected eye specimens (e.g. corneal scraping or vitreous/aqueous fluids) are collected

Invasively-collected eye sample

(e.g. corneal scrapings or vitreous/aqueous fluids)

Eye Invasive Culture (M/C/S)

If other tests required, add onto the same specimen; e.g. fungal culture (test code: Fungal Culture (M/C/S)), viral/other PCRs (test codes: Adenovirus PCR, HSV Type 1 PCR, HSV Type 2 PCR, VZV Varicella PCR, Toxoplasma PCR, etc)

Acanthamoeba culture: Enter information in ‘Order Comments’ and contact laboratory for specific media

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Genital swab sample Genital Swab Culture (M/C/S)

Low vaginal swabs for group B streptococcal screening: use test code Group B Streptococcus Culture Screen (M/C/S) instead

Urine/endocervical etc specimens for sexual transmissible pathogens: use appropriate test codes (e.g. Chlamydia trachomatis PCR, Neisseria gonorrhoea PCR and Trichomonas vaginalis PCR) instead

Intravascular device tip Tip Culture (M/C/S) Do not send device tips other than from intravascular devices without contact with Clinical Microbiologist

Nasal staphylococcal carriage screen

Staphylococcus aureus Screen Culture

In accordance with Renal Unit protocol only

Multiresistant organism screen

Methicillin-resistant Staphylococcus aureus (MRSA)

MRSA Screen Culture

Vancomycin-resistant enterococci (VRE)

VRE Screen Culture

Multiresistant Gram negative organisms

ESBL/MRGN Screen Culture

Skin Scrapings, Hair, Nail (Dermatophyte fungi and / or Scabies)

Skin Scrapings, Nail, Hair collected in sterile container (Do not include sharps)

Skin, Hair, Nail Dermatophyte Culture (M/C/S)

If Scabies examination (test code: Parasites OCP Microscopic Examination (Non – Faeces Only) add on to the same specimen.

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Serology Ordering Guide

In general, the nomenclature of test codes is as follows:

Antibody detection: [Organism name or syndrome] followed by Serology ± followed by [Antibody type]

For example, Barmah Forest Virus Serology IgM

Antigen detection: [Organism name or syndrome] followed by Antigen

For example, Dengue NS1 Antigen

Nucleic acid amplification (PCR): [Organism name or syndrome] followed by PCR ± followed by [Quantitative orQualitative]

For example CMV PCR Quantitative

Intended request: syndromes/pathogen

groups

Specific pathogens

Test code(s) in ieMR Notes

Hepatitis viruses Hepatitis A virus: individual markers

Hepatitis A Serology IgM Test for recent hepatitis A infection

Hepatitis A Serology IgG Test for immunity from past hepatitis Ainfection or vaccination

Hepatitis A PCR Test for confirmation of hepatitis A IgMor for diagnostic use and genotyping

Hepatitis B virus: individual markers

Hepatitis B Serology Surface Antigen

Test for acute or chronic hepatitis Binfection

Hepatitis B Serology Surface Antibody

Test for immunity from past hepatitis Binfection or vaccination

Hepatitis B Serology Core Antibody

Test for recent or past hepatitis Binfection

Hepatitis B Serology Core Antibody IgM

Test for recent hepatitis B infection

Hepatitis B Serology e Antigen Test for increased hepatitis B infectioninfectivity (only request if Hepatitis BSurface Antigen is positive)

Hepatitis B Serology e Antibody

Test for lower hepatitis B infectioninfectivity (only request if Hepatitis BSurface Antigen is positive)

Hepatitis B Serology Surface Antigen Quantitative

Test for monitoring of anti-viral therapyof hepatitis B; not for diagnosis

Hepatitis B PCR Qualitative Test for screening of solid organ andtissue donors

Hepatitis B PCR Quantitative Test for monitoring of anti-viral therapyof hepatitis B; not for diagnosis

Hepatitis B Sequencing for YMDD Mutation

Test for lamivudine resistance mutation

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groups

Specific pathogens


Hepatitis B virus: multiple markers

Hepatitis B Full Screen Test for hepatitis B infection status; includes: Hepatitis B Surface Antigen, Hepatitis B Surface Antibody, and Hepatitis B Core Antibody

Hepatitis C virus: individual markers

Hepatitis C Serology Test for diagnosis of hepatitis C infection

Hepatitis C Antigen Test for diagnosis in seronegative ‘window period’

Hepatitis C PCR Quantitative Viral Load

Test for monitoring of anti-viral therapy of hepatitis C; not for diagnosis

Hepatitis C Genotyping Test for prediction of respond to anti-viral therapy

Acute hepatitis A, B, and C virus: multiple markers

Acute Hepatitis A/B/C Screen Test for acute hepatitis A, B, C infection; includes: Hepatitis A IgM, Hepatitis B surface antigen, Hepatitis B surface antibody, Hepatitis B core total antibody and Hepatitis C antibody

Hepatitis D: individual markers

Hepatitis D Serology Test for hepatitis D infection (only request if evidence of current hepatitis B infection)

Hepatitis D PCR Test for confirmation and management of hepatitis D infection [requires authorisation]

Hepatitis E: individual markers

Hepatitis E Serology Test for hepatitis E infection. Test only performed with appropriate travel history or animal contact

Herpes group viruses

Herpes simplex viruses (HSV)

HSV Type 1 and 2 Serology IgG Test for past infection with HSV type 1 and/or type 2. Test not generally useful for diagnosis of primary HSV infection (use test codes HSV Type 1 PCR, HSV Type 2 PCR)

HSV Type 1 PCR, HSV Type 2 PCR

Test for active (primary or recurrent) HSV infection. Test performed on dry vesicle swabs, CSF, invasively-collected eye specimens etc

Cytomegalovirus (CMV)

CMV Serology IgG Test for past infection with CMV

CMV Serology IgM Test for recent (primary or recurrent) infection with CMV

CMV Avidity Tests for avidity of CMV IgG only where the diagnosis of acute primary infection is critical (e.g. in early pregnancy)

CMV PCR Qualitative Test for severe (e.g. central nervous

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groups

Specific pathogens


system or tissue-invasive) CMV infection only. Test performed on serum, CSF, invasively-collected eye specimens, tissue specimens etc

CMV Quantitative Test for quantitative detection of CMV DNA in blood specimens of immunosuppressed patients only

Epstein Barr virus (EBV)

EBV Serology IgG Test for past infection with EBV

EBV Serology IgM Test for recent (primary or recurrent) infection with EBV

EBV PCR Test for severe (e.g. central nervous system or tissue-invasive) EBV infection only. Test performed on serum, CSF, tissue specimens etc

Varicella zoster virus (VZV)

VZV Serology IgG Test for past infection with VZV

VZV Serology IgM Test for recent (primary or recurrent) infection with VZV

VZV Varicella Zoster PCR Test for active (primary or recurrent) VZV infection. Test performed on dry vesicle swabs, CSF, invasively-collected eye specimens etc

Other human herpes viruses

Human Herpes Virus Type 6 Serology IgM

Test for recent HHV-6 infection

Human Herpes Virus 6 PCR Test for severe (e.g. central nervous system or tissue-invasive) HHV-6, -7, or -8 infection only. Test performed on serum, CSF, tissue specimens etc

Note HHV-7 and -8 PCR tests are not performed at Pathology Queensland [requires authorisation]

Human Herpes Virus 7 PCR

Human Herpes Virus 8 PCR

Pneumonia Legionella spp. Legionella Serology Serological diagnosis best made with paired acute and convalescent (i.e. 10-14 days later) serum samples

Legionella Urinary Antigen Only detects Legionella pneumophila serogroup 1

Chlamydia (Chlamydophila) pneumoniae or C. psittaci

Chlamydia pneumonia Serology IgA and IgG or Chlamydia pneumonia Serology or Psittacosis Serology

Serological diagnosis requires paired acute and convalescent (i.e. 10-14 days later) serum samples. Acute sample will be stored and not tested until receipt of second sample

Mycoplasma pneumonia

Mycoplasma pneumonia Serology or Atypical pneumonia Serology

Note that test code Atypical Pneumonia Serology will only have Mycoplasma pneumoniae serology performed. Other markers are required to be specifically

35


groups

Specific pathogens


requested

Streptococcus pneumoniae

Streptococcus pneumonia Urinary Antigen

Do not request test code Pneumococcal Serology (test only performed for assessment of immunodeficiency)

Haemophilus influenzae

Nil specific tests Do not request test code Haemophilus influenza Type B Serology IgG (test only performed for assessment of immunodeficiency)

Bordetella pertussis

Bordetella pertussis Serology IgA

Test for recent pertussis infection [Not suitable for immune status or post-vaccination check]

Bordetella pertussis PCR Test for active pertussis infection. Test performed on nasopharyngeal swab or nasopharyngeal aspirate

Respiratory viruses

Respiratory Virus PCR – Respiratory Syncytial Virus Direct Antigen Test performed here first on aspirates from patients <5 years old]

Test only performed on nasopharyngeal swab, nasopharyngeal aspirate, or bronchoscopically-collected respiratory tract specimens

Cryptococcus neoformans

Cryptococcal Antigen Test can be performed on serum or CSF

Aspergillus spp. Aspergillus Galactomannan Antigen

Test can be performed on serum or bronchoscopically-collected respiratory tract specimens. In general, not a routine test. Contact Clinical Microbiologist or Infectious Diseases Physician [requires authorisation]

Do not request test code Aspergillus precipitins (test only performed for assessment of allergic bronchopulmonary aspergillosis)

Meningitis/ encephalitis

Neisseria meningitidis

Neisseria meningitidis PCR or Meningococcal PCR

Test performed on CSF or EDTA blood

Streptococcus pneumoniae

Streptococcus pneumonia PCR Test performed on CSF or EDTA blood

Herpes simplex viruses

HSV Type 1 PCR and HSV Type 2 PCR

Do not request test codes HSV Type1 and Type 2 Serology IgG for suspected herpes meningoencephalitis

Enteroviruses Enterovirus PCR Do not request test code Enterovirus Serology or Coxsackie virus Serology for suspected enteroviral meningitis

Cryptococcus spp. Cryptococcal Antigen Test for direct detection of cryptococcal antigen in serum or CSF

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groups

Specific pathogens


India Ink Stain for Cryptococcus microscopy

Test for direct detection of cryptococcal cells in CSF

Viral exanthems Measles Measles Virus Serology IgG Test for immunity from past measles infection or vaccination

Measles Virus Serology IgM Test for recent measles infection

Measles Virus PCR Test for active measles infection. Test performed on dry throat swab or urine. Contact with Infectious Diseases Physician, Clinical Microbiologist, or Public Health Physician required prior to request

Mumps Mumps Serology IgG Test for immunity from past mumps infection or vaccination

Mumps Serology IgM Test for recent mumps infection

Mumps PCR Test for active mumps infection. Test performed on dry throat swab or urine.

Rubella Rubella Serology IgG Test for immunity from past rubella infection or vaccination

Rubella Serology IgM Test for recent rubella infection

Rubella Virus PCR Test for active rubella infection. Test performed on serum.

Parvovirus Parvovirus B19 Serology IgG Test for past parvovirus infection

Parvovirus B19 Serology IgM Test for recent parvovirus infection

Parvovirus B19 PCR Test for severe parvovirus infection. Test performed on blood, bone marrow tissue, other tissues etc

Arboviruses Ross River virus Ross River Virus IgM Test for recent Ross River virus infection

Barmah Forest virus

Barmah Forest Virus IgM Test for recent Barmah Forest virus infection

Dengue virus

Multiple markers

Dengue NS1 antigen and Dengue Virus IgM and Dengue Virus IgG

Test for recent or past Dengue virus infection

Dengue Virus PCR Test in conjunction with Dengue NS1 antigen and Flavivirus Serology

Test useful in early illness stage when serology may be negative

Flavivirus Group Serology Test for flaviviruses (including both Dengue and encephalitic flaviviruses)

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groups

Specific pathogens


Flavivirus Group PCR Test for flaviviruses (including both Dengue and encephalitic flaviviruses)

Zoonoses Q Fever Q Fever Serology Test for recent or past Q Fever infection. Indicate if chronic Q Fever is clinically suspected

Q Fever Pre-vaccination Screen

Test for pre-vaccination screening

Q Fever PCR Test should only be requested in early stage of severe Q Fever illness. Contact laboratory

Rickettsial diseases

Rickettsia Serology Tests for both spotted fever group (e.g. R. australis/Queensland tick typhus) and scrub typhus group (e.g. O. tsutsugamushi) rickettsial diseases

Spotted Fever Serology Tests for spotted fever group (e.g. R. australis/Queensland tick typhus) rickettsial disease

Scrub Typhus Serology Tests for scrub typhus group (e.g. O. tsutsugamushi) rickettsial diseases

Bartonellosis/Cat scratch disease

Bartonella henselae Serology IgG or Cat Scratch Disease Serology

Test for recent or past infection with B. henselae

Bartonella henselae PCR Test performed on tissue or fluid

Brucellosis Brucella Serology IgG and IgM Test for recent or past infection with Brucella spp.

Leptospirosis Leptospirosis Serology IgM Test for recent infection with Leptospira interrogans sp

Leptospirosis PCR Test useful in early illness stage when serology may be negative

Leptospirosis Culture Test performed on blood. Contact laboratory

Lyme disease Lyme Serology- Provide Travel History

Test performed only with appropriate travel history

Toxoplasmosis Toxoplasma Serology IgG Test for past infection with Toxoplasma gondii

Toxoplasma Serology IgM Test for recent (primary or recurrent) infection with Toxoplasma gondii

Toxoplasma Serology IgG and IgM

As above

Toxoplasma PCR Test for severe active (primary or recurrent central nervous system or tissue-invasive) toxoplasmosis Test performed on CSF, invasively-collected

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groups

Specific pathogens


eye specimens etc

Hydatid disease Hydatid Serology or Echinococus granulosis Serology

Test for recent or past hydatid infection

Amoebiasis Amoebiasis Serology or Entamoeba histolytica Serology

Test for recent amoebiasis

Strongyloidiasis Strongyloides Serology Test for recent strongyloidiasis

Faeces may be cultured for Strongyloides stercoralis: contact laboratory

Schistosomiasis Schistosomiasis Serology Test for recent schistosomiasis

Exotic or travel-related infections

Various pathogens

Various tests possible Contact Infectious Diseases Physician or Clinical Microbiologist for specific advice

Rheumatic Fever disease

Group A streptococci

Streptococcus Group A Serology Antistreptolysin O ASOT Anti Dnase B

Tests for both ASOT and anti-DNase B

Syphilis Syphilis screening Syphilis Serology Tests initially for Syphilis EIA; if positive, TPPA and RPR performed

Do not routinely request test codes Treponema pallidum Serology IgM or FTA

Syphilis treatment follow up or children under 1 year

RPR Test for treatment follow up or children under 1 year

Neurosyphilis CSF VDRL Test performed only on CSF

Syphilitic chancre Treponema pallidum Syphilis PCR

Test performed only on dry swab of syphilitic chancre

HIV HIV screening HIV Serology Antibody/Antigen

Additional HIV tests should only be requested with expert advice

Occupational/needle stick exposures

From source patient

Needle stick injury – Source/Patient

Tests for Hepatitis B surface antigen, Hepatitis C antibody, and HIV antibody/antigen

From recipient/staff member: initial test

Needle stick injury – Recipient/Staff Member

Tests for Hepatitis B surface antibody, Hepatitis C antibody, and HIV antibody/antigen

From recipient/staff member: follow up test

Needle stick injury – Follow Up Tests for Hepatitis C antibody and HIV antibody/antigen

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Sexually Transmitted Infections

Chlamydia trachomatis

Chlamydia trachomatis PCR Test performed on dry swab and/or first catch urine

Neisseria gonorrhoea

Neisseria gonorrhoea PCR Test performed on dry swab and/or first catch urine

Trichomonas vaginalis

Trichomonas vaginalis Test performed on dry swab and/or first catch urine

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