Laboratory and specimen transport personnel should be familiar with the hospital's specimen types and quantities, transport types and methods, and comply with relevant laws and regulations on specimen transfer and storage.
Transport personnel should maintain a stable and regularly reviewed training and assessment on specimen transport knowledge.
Laboratories should establish requirements for specimen packaging and transport timelines.
When transporting infectious materials outside the hospital, specimen packaging and safe transport should comply with relevant national and local laws and regulations.
Laboratories should monitor and manage temperature, time, and route during specimen transport.
Laboratories should establish standards and procedures for specimen acceptance and rejection, and maintain records of specimen acceptance and rejection.
Automated logistics systems should be regularly evaluated. When necessary,sample types and testing items that are not suitable for automated logistics systems should be specified.
Laboratories should establish a time limit for clinical specimen retention and a process for handling discarded specimens.
Laboratories should establish a closed-loop monitoring and management system for digitized specimens, including the application, collection, handover, computerization, review, release, printing, and destruction processes.
Laboratories should establish emergency response procedures for incidents such as specimen spillage and specimen loss. Laboratories should integrate management requirements for sample transport and storage within their existing quality management systems.
Specimen Classification and Transport Regulations
Clinical specimen types include blood, urine, stool, cerebrospinal fluid, nasal/pharyngeal swabs, and pathological tissue. Blood is the most common, accounting for approximately 80%. Based on the urgency of the test, specimens can be categorized as green channel, emergency, and routine. Based on the hospital location, transfers can be divided into intra-hospital and inter-hospital transfers, which are further categorized as inter-hospital and commissioned specimen transfers.
Specimens confirmed or suspected to be highly pathogenic microorganisms, bacteria, or viruses must be transported with relevant permits in accordance with the "Regulations on the Transportation of Highly Pathogenic Microorganisms, Bacteria, or Viruses that Can Infect Humans."
The entry and exit management of special items such as microorganisms, human tissue, biological products, blood, and its products is governed by the "Regulations on the Sanitary Quarantine Management of Entry and Exit of Special Articles," issued by the General Administration of Quality Supervision, Inspection, and Quarantine (AQSIQ) Order No. 160.
Transport Personnel Qualifications and Training
To ensure that the transport process does not affect test results, that specimens are delivered to the laboratory in a timely manner, and that safety is maintained during transport, as well as the ability to initiate emergency response measures in the event of an incident, transport personnel should be relatively fixed and regularly trained (see original text for details).
Because the method and timing of specimen transport can be affected by various factors, which may lead to errors in test results, transport personnel must receive relevant professional training to master storage and transport methods. They must pass the relevant assessment before taking up their posts and receive regular annual training.
Packaging and Time Limit Requirements for Transported Specimens
When transporting clinical laboratory specimens within the hospital, they should be packaged in specimen bags bearing biohazard labels to prevent contamination of other specimens and transport containers through leakage. Non-blood specimens should be packaged individually in specimen bags. The specimen bags should be labeled with a barcode indicating the packaging person, time of packaging, and number of specimens. The specimen bags should be placed in dedicated specimen transport boxes.
Specimens should be transported in dedicated transport boxes that maintain a stable temperature. Proper fixtures or cushioning should be placed inside the transport box to minimize mechanical damage during transportation or to mitigate the effects of vibration and pressure fluctuations (such as those caused by traffic accidents during transportation).
The laboratory should establish documentation specifying the specifications of the specimen transport box, internal storage contents, spill prevention measures, external labeling, and contact persons. Pretreatment methods and stabilization times vary for different testing items. For long-distance transport, such as across campuses, pretreatment is generally performed by the collector.
Handover and Acceptance of Transported Specimens
Before specimen transport, the collector should re-verify the medical instructions, inspect the specimen quality, and verify the number of specimens before handing them over to the transporter. Handover details should include delivery time, delivery temperature, specimen number, and specimen integrity. The handover location should meet biosafety requirements. If specimens cannot be sent for testing promptly, they should be temporarily stored in appropriate environments and storage conditions.
For manual transport, real-time monitoring of the transport environment, including temperature, time, route, and location, is recommended. To ensure safe transportation, hospitals implement dedicated personnel for transport management, use sealed containers for transport, maintain fixed routes, and implement strict handover registration, recording the time and personnel involved. Furthermore, they have emergency measures in place to prevent contamination.
During transportation, test tubes must be kept upright to minimize shaking and vibration, prevent spillage and contamination, and maintain biosafety. If a paper test application form is required, it should be delivered with the specimens to prevent contamination. Transport personnel must verify that the sample quantity matches the inspection list, that no samples have been leaked, and that the specimens are safely delivered to the destination in sealed containers.
When third-party testing agencies transport specimens across cities, they should establish a management system to ensure the integrity and safety of transportation equipment, including transportation methods, temperature control equipment, human resources, sample containers, and protective equipment. Drones may be used for sample transportation when necessary.
Laboratories can define acceptance and rejection criteria for various types of specimens based on methodology and other information. Upon arrival at the laboratory, specimens should be promptly inspected and accepted, and confirmed upon receipt. Inspection and acceptance criteria include complete application information, correct sample type, appropriate sample quantity, and timely delivery. Record all received samples, including the recipient, date and time of receipt. When unqualified specimens are found during acceptance, they shall be recorded and handled according to the unqualified specimen management process.
Requirements for automated logistics systems
Common hospital logistics transmission systems include medical pneumatic tube transmission systems, rail-type logistics transmission systems, automated guided vehicle transmission elevated monorail trolley transmission systems, aerial transmission systems, fully automatic intelligent blood collection tube sorting systems, etc.
Result impact evaluation, biosafety assessment, quality risk assessment, and operational efficiency assessment should be conducted on automated logistics systems (see original text for details).
Application evaluation opportunities include:
(1) When installing or replacing a new automated logistics system;
(2) When the location, distance, floor, etc. of the automated logistics system are changed;
(3) The laboratory formulates an evaluation cycle based on usage.
The main operator of the automated logistics system must undergo special training and be authorized by the laboratory manager (see original text for details of the training content).
Establish an emergency plan for automated logistics system failures so that when the automated logistics system fails, it can be handled correctly or an alternative method can be adopted.
Sample Storage
Sample storage includes temporary storage for samples that the collection department fails to deliver to the testing laboratory in a timely manner, as well as post-test storage. For temporary storage, samples should be placed within staff visibility or monitored to prevent loss or forgetfulness. It is recommended that storage boxes be locked and only accessible to authorized personnel. Some samples should be pre-processed or stored in a refrigerator. Raw samples after testing should be arranged in order, dated, and sealed, and stored in separate, refrigerated areas for review and verification in the event of disputes or appeals. Specific storage periods can be determined by the laboratory based on space, facilities, and needs.
If a laboratory tests positive for highly pathogenic microorganisms such as human immunodeficiency virus, samples should be transferred to the local CDC for processing. Unless otherwise indicated by the test results, tested samples should be disposed of as medical waste after the specified storage period. If samples are retained for research, they should be managed as research samples and must be approved by the hospital's ethics committee.
Tracking and Monitoring the Transport Process
To track the whereabouts of samples, the number of samples, date and time, transporter, and method of transportation for each transfer should be recorded. The number and detailed information of each transfer can be tracked. Applying timeline control to the entire laboratory process provides managers with effective data for monitoring and analyzing flow times. Controllable timelines within the laboratory process include: test request, sample collection, handover between nursing and logistics, laboratory receipt, sign-off by various professional teams, on-board testing, test completion, result review, result release, report query or printing, and sample destruction.
Alerts can be set at each node or for specific steps to indicate timeline requirements for transportation. In the event of an emergency, real-time alerts are provided for each stage, including order issuance, sample collection, post-collection transport, and laboratory receipt. In the event of critical value results, alerts are provided for each stage, including instrument transmission, result review, report delivery, and clinical result review.
Emergency Response to Accidents During Transportation
A spillage kit should be provided during transportation, including medical waste bags, gauze, medical gloves, disposable tweezers, and disinfectant wipes. Accidents during transportation primarily include sample spillage and sample loss. Laboratories should establish procedures for handling blood (or body fluid) spills. In the event of a small amount of blood (or body fluid) spillage (<10ml), use a spill bag and take personal protective measures, including gloves and, if necessary, protective clothing, eye protection, and goggles. Cover the contaminated area with a cloth or paper towel, absorb the blood (or body fluid), and place it in a yellow garbage bag. Clean from the outside in with disinfectant wipes until no blood (or body fluid) is visible to the naked eye. Change gloves. Wipe from the outside in with disinfectant wipes, moisten them, and allow them to dry naturally for 2-3 minutes. Remove gloves, perform hand hygiene, and record the handling process. Unqualified samples due to spillage, temperature loss, time delays, etc. should be recorded and reported promptly.
Your message must be between 20-3,000 characters!