Lab Information

·  REQUEST FORM INFORMATION

The laboratory uses standard request forms to control the ordering of common laboratory requests. The laboratory accepts/receives two types of request forms in our laboratory.

a) Fomema Medical Examination Form

Pre-printed from Fomema with foreign worker and clinician identification, the clinician provides date of sample collection. Clinic shall check and ensure the clinic name and laboratory name on Fomema Medical Examination Form are correct before proceeding to draw the foreign worker’s blood.

b) Pathology Request Form (for commercial sample) The essential information on the request form are:

·         Patient’s full name

·         Patient’s IC or Passport number

·         Patient’s date of birth

·         Patient’s worker code

·         Patient’s gender

·         Date and time of specimen collection

·         Type of specimen collected and if appropriate. E.g: The anatomical site of origin or tick the relevant box

·         Specimen nature

·         Report Urgency

·         Name of the clinician

·         Location to where the results should be reported

·         Test requested

·         Clinical history, clinical advice and diagnosis if needed.

· TEST PREPARATION NEEDED

Fomema Test

No fasting is required. For female, ensure patient is not menstruating before collection of the urine sample.

Lipid Profile

For optimal results, the patient should be on a stable diet for 2-3 weeks prior to testing. Patient should fast for 12 to 14 hours before blood collection. Fasting includes no food or drink except for plain water.

Glucose Tolerance Test GTT (Non-Pregnant)

Patient should be fasting for 12 to 14 hours (no food or drink, except for water). A blood specimen will be drawn after which the patient will be given a special drink. Patient’s blood will be drawn once each hour after the patient has finished the drink. The number of blood draws may vary and patient may be required for blood draws from 2 to 6 hours. Patient’s doctor will decide how many hours blood draws will be required per patient. Sufficient time should be allowed for GTT to be completed. Patient will need to allow approximately one hour more than the number of hours patient’s physician requested. For example, if patient’s physician ordered a 2 hour glucose tolerance, then three (3) hours should be allowed for the GTT to be completed.

Cortisol

Cortisol may be tested in blood or urine.

If blood cortisol levels are requested by patient’s physician, patients may be asked to have blood drawn once (random cortisol) or multiple times. Patient’s physician will inform patient if patient is required to have multiple blood draws for patient’s cortisol testing. Cortisol blood tests may be drawn at about 8 am, when cortisol should be at its peak, and again at about 4pm, when the level should have dropped.

If patient’s physician requests urine cortisol, patient will be asked to collect either a 24- hour urine or a single first morning specimen. Patient’s physician will inform patient of the type of urine collection patient will need.

Vitamin B12 and Folate

A fasting specimen (no food or drink, except for water) for 12- 14 hours before blood is drawn is preferred. However, patient’s physician may request that patient have patient’s blood drawn when patient is not fasting.

Prenatal Glucose Tolerance Test (Prenatal GTT)

Patient’s physician may order glucose tolerance testing during patient’s pregnancy.

  1. This test should be performed in the morning after an overnight fast of at least 8 hours but not more than 14 hours and after at least 3 days of unrestricted diet and activity.
  2. A blood specimen will be drawn and
  3. Patient will then be given a special
  4. Patient’s blood will be drawn once each hour for 2 hours (glucose tolerance 2 point and 3 point) or every half hour for 2.5 hours (glucose tolerance 6 point) after patient finishes the
  5. Sufficient time should be allowed for this prenatal GTT test. Patient will need to allow at least 4 hours for this test to be

24 Hours Urine Specimen

The following instructions should be followed in collecting patient’s 24-hour urine specimen.

Do not add anything but urine to the container and do not pour out any liquid or powder that may already be in the collection container. These substances may cause burns if touched.

The collection container should be kept cool throughout the collection period.

  1. Upon awakening in the morning, patient should urinate in the toilet, emptying the bladder completely. Do not collect this sample. Note the exact time on the container label.
  2. Collect all urine voided for 24 hours after this time in the container provided. All urine passed during the 24-hour time period (day and night) must be Urine passed during bowel movements must also be collected. Be careful not to contaminate urine specimen with feces.
  3. Refrigerate the collected urine between all voidings or keep in a cool
  4. At exactly the same time the following morning, void completely again (first time after awakening) and add this sample to the collection container. This completes the 24-hour collection.
  5. Be sure to label specimen with patient’s name, date and time the collection began and ended.
  6. Take the 24-hour specimen to the clinic/patient’s physician as soon as

24 Hours Creatinine Clearance Collection

  1. Obtain a collection container from the clinic/patient’s physician
  2. Follow the directions for 24-hour urine
  3. Have patient’s blood drawn either at the beginning, during or end of the collection period. A blood sample is needed in conjunction with the 24-hour urine collection in order to complete the testing.
  4. Please label the container with the patient’s name, date, and time the collection began and ended.
  5. Include the patient’s height and
  6. Return patient collection container to the clinic/patient’s

Semen Analysis

  1. Refrain from sexual intercourse or masturbation for between 2 and 7
  2. Produce the sample by masturbation without artificial lubricants. Do not use a condom, as condoms contain spermicidal
  3. Collect the sample into the clean, wide mouth container supplied. It is important that the whole ejaculate is If not, the specimen should be labeled as incomplete.
  4. Within 1 hour of collection, bring the sample to the MediSCAN

Sputum for Culture and Acid Fast Bacilli (AFB)

  1. Collect specimen from deep cough into a sterile
  2. Patient should avoid any contamination with
  3. Send the specimen to Mediscan Laboratory as soon as

Other test

There is no need for test preparation.

· SPECIMEN LABELLING

The laboratory shall accept the specimens which are labelled with minimum of two identifiers:

  1. Name of foreign worker/ Patient
  2. Worker code or Passport number / IC

· SPECIMEN COLLECTION

Specimen collection containers are supplied by the MediSCAN Laboratories.

Types of Specimen Collection Containers

Blood Collection Containers – Common Vacutainer Tubes

Other Specimen Collection Containers

· HANDLING AND TRANSPORTATION

The specimen collected from patients are to be kept in refrigerator 2-8⁰c until collected by MediSCAN despatchers. The dispatchers bring along a running sheet when visiting the clinic, minimum one visit per day except for on-call basis when requested by clinic. The collected sample and request form by clinic must be inserted into the biohazard bag provided and collected by dispatch. Dispatchers are responsible to ensure that the time of visit, clinic stamp and the signature of clinician / nurse in charge is obtained as an acknowledgement

of the routine visit. The dispatch records down the number of samples collected from the clinic into the running sheet according to the respective clinic visited and ensures the entire sample is put into the iced-bag as soon as it’s collected from the clinic.

· TEST OFFERED

Test offered in our laboratory is mentioned in MediSCAN’s price catalog, it also includes specimen type, specimen volume and pricing.

  • SPECIMEN ACCEPTANCE AND REJECTION CRITERIA

   Sample will be rejected in the following situations:

  • Unlabelled sample:

No name, IC, worker code or passport no. labelled on the sample received.

  • Mislabelled sample:

Patient name or IC or worker code or passport no. was labelled differently from request form.

  • Improperly/ Incompletely labelled sample:

Refer to Fomema’s SOP, minimum two (2) identifiers are needed, patient name and worker code or passport no.

  • Insufficient sample:

Sample is not enough to perform the testing and confirmation process. Refer to Fomema’s SOP, the minimum requirement for sample volumes received are:

  • Not less than 5ml of Plain tube;
  • Not less than 2ml of EDTA tube;
  • Not less than 30ml of Urine
  • Haemolysed blood sample:

Hemolysis can occur from two sources, In-vivo hemolysis and In-vitro hemolysis.

  1. In-vivo hemolysis may be due to pathological conditions, such as autoimmune hemolytic anemia or transfusion
  2. In-vitro hemolysis may be due to improper specimen collection, specimen processing, or specimen
  • Misallocation, laboratory or clinic (Applicable for Fomema sample only):

Sample collected from unauthorized clinic or sample belongs to other authorized laboratory.

  • Improper sample types received:

Wrong sample types received and the lab is unable to perform the requested test.

  • Others

Sample spillage due to loose or improperly closed sample cup.

Unsatisfactory commercial sample will still be processed. However, the sample condition will be reported as ‘unsatisfactory sample condition’ in the laboratory report.

· TURN AROUND TIME

For Fomema samples, MediSCAN Laboratories is responsible to ensure transmission of Fomema result within 72 hours after the specimen collected from foreign worker. In Klang Valley, hardcopy report will be sent within 2 days of receipt of specimens. In Collecting Centres, hardcopy report will be sent within 3-4 days of receipt of specimens.

For urgent samples FBC & Dengue Studies, the turn-around time is within 2 hours upon arrival in laboratory department.

· LIMITATION OF THE TEST

Specimens which are haemolysed, lipaemic and icteric may cause interference on the test results.

· PROTECT PERSONNEL INFORMATION

The Management of MediSCAN Laboratories, keeps all protected information secure and confidential and is our primary concern and obligation. We are committed to keeping all confidential information safe from any unauthorized person and the integrity of all laboratory test results and reports to be valid and reliable.

· USER SATISFACTION AND COMPLAINTS

There are two methods of complaints to MediSCAN Laboratories, verbal and written complaints. Verbal complaint through phone conversation; written complaint through formal letter, e-mail (lab@mediscan.com.my) and fax. In all cases, it is department policy to respond in an open, positive and professional manner to issues raised.

MediSCAN Laboratories performs annual customer satisfaction survey in order to improve our service.