JAH Lab Bulletin No.

2, April 2010
Kindly note that laboratory is now performing following tests in-house: D-Dimer, HbA1C and Microalbumin
NEW LABORATORY REQUEST FORMS
Kindly note that a newly designed laboratory request form is being implemented
Please take the time to look at the new laboratory request form and make sure you are aware of what
information is needed to ensure that the request is processed.
NOTE:
All laboratory requests must be SIGNED by the REQUESTING DOCTOR.

MINIMUM CRITERIA FOR REQUEST FORMS AND SAMPLES

The minimum acceptable criteria for completion of The minimum acceptable criteria for identification
request forms are: of samples are:
Patient Registration Number* Patient registration Number
Patient Name Patient Name
Date of Birth (Age) Date of Birth
Gender Gender
Requesting Doctor
Doctors Signature
Tests Requested
Date tests requested All entries on request form should be written clearly
Test Urgency and legible
Date and Time of Collection** If the standard of completion of request forms is poor it
Sample Type ultimately represents a threat to patient safety.
Sample collected by (if samples sent to lab with If vital information is lacking it can cause difficulties in
identifying patients for the phlebotomy staff and delays in
request form)
processing samples in the laboratory.
NOTE: RELEVANT CLINICAL HISTORY HIGHLY
It is the duty of the requesting doctor to ensure completion
DESIRABLE
of the request form correctly; these forms are kept for
* For patient details please use patient labels if possible several years and are legal documents.
** Collection date and time and sample type must be provided The laboratory has a right to reject request forms that are
and the person collecting the sample must initial the form. not correctly completed.
For Transfusion Medicine samples must be labelled with
signature of collector and date and time of collection
* Proper record keeping (retention) of completely filled
laboratory request forms is required by
Joint Commission International (JCI) and other
accreditation bodies.
TESTS AVAILABLE WITH STAT/URGENT PRIORITY
Chemistry URINALYSIS
Amylase Dipstick screen and microscopic, if indicated
CPK(total) & CK-MB
Electrolytes BLOOD BANK
Troponin I Blood typing
Crossmatch
Hematology
CBC MICROBIOLOGY
WBC Staining and examination od smears in urgent cases, e.g.
RBC CSF in suspected meningitis
Hemoglobin
Indices
WBC differential
OTHER
Platelet Count Pregnancy test
Strep A Antigen
COAGULATION Rapid flu
Prothrombin Time (PT)
Partial Thromboplastin time (PTT)
D-Dimer