Pertussis investigations:

1. Department of Clinical Pathology Service User Newsletter; Edition 1, June 2013 Welcome! Thank you to all those who responded to our user survey and to those who attended the clinical user’s meeting earlier this year. Any concerns raised have been discussed at departmental meetings and corrective actions implemented.We would like to welcome you to this first edition of the Department of Clinical Pathology Newsletter, published every 6 months to update you on our service. • Pertussis investigations: • Requests for Bordetella culture or PCR should only be made within 3 weeksof cough onset. A pernasal swab is required (available from the Microbiology Laboratory) and samples need to be transported to the Laboratory immediately. • Serology should be only requested after 3 weeks of cough onset and is only appropriate if the child is over 12 months and has not been vaccinated in the previous 12 months. • Ova, cyst and parasite requests: • In order to screen only appropriate samples for evidence of parasitic infection, the Microbiology laboratory will only process faeces samples for OCP in cases where there is: • Prolonged diarrhoea (>2 weeks) • Significant travel history • Epidemiological link to a known outbreak • Exposure to a potential source of infection • Immunosuppression, or other risk factor • Samples will only be processed for OCP if one or more of the above are indicated on the request form, or if the request has been discussed with the Consultant Microbiologist. • GP request forms: • We receive a number of requests using forms from other hospitals (e.g. Mater Misericordiae). This leads to delays as the samples are delivered to that hospital in the first instance. Can all GP service users ensure that samples intended for Temple Street are requested using our GP request form only. • Providing relevant clinical details on the request form enables the laboratory to perform the full and appropriate range of investigations. For Microbiology requests, any antibiotic therapy should also be included. • We are currently redesigning our GP request form and would welcome any comments on the design and content, contact details are given at the end of this newsletter. iPiMS labels: The National Virus Reference Laboratory are unable to accept request forms sent with orange iPiMS labels. Any such requests received with orange labels will be held until a replacement form is provided. New white labels are now available and should be used for all Pathology requests. • Pneumatic tube system: • Hospital users may be aware of the ongoing installation of the pneumatic tube system linking key clinical areas with the laboratory. Remote stations for the rapid transport of pathology specimens are currently being installed in the following areas: • Accident & Emergency • ICU • Phlebotomy • St. Michael’s B • St. Michael’s C • The pneumatic tube should be fully installed and operational within the next few months. Information regarding the use of the system and a schedule of user training will be issued shortly. Thank you for your cooperation during the installation process. • The National Healthlink Project provides a web-based messaging service which allows the secure transmission of clinical patient information in real time, including pathology results, between Hospitals, Health Care Agencies and General Practitioners. • Following a successful pilot earlier this year five GP practices are now receiving pathology reports from Temple Street laboratories, these are: • Drumcondra Clinic • Ballymun Family Practice • Manor Street Family Practice • Beaumont Park • Kirkfield Clinic • We have a long waiting list of additional GP practices that have expressed interest and are part of a planned roll out, please be patient while we make the service available to more of our users. Further information can be found at: www.healthlink.ie Temple Street Children’s University Hospital Department of Clinical Pathology Newsletter. Edition 1, May 2013. UI/2013/001 P Please consider the environment before printing

2. General Pathology User Survey: In November 2012 the User Survey was distributed to our hospital users and GPs. We received 34 responses in total. Survey Monkey was used for the first time this year, along with email and printed survey forms. The 2013 user survey will be made available to our GP users during the Temple Street GP Study Night, information about which will follow in due course. There were no “Poor” ratings this year compared to 16% total poor ratings last year. There has been an increase in the percentage of users happy with the service that we provide. Accreditation: All pathology departments continue to be accredited by CPA Ltd (UK). In addition, the Blood Transfusion laboratory successfully maintained accreditation to ISO 15189 standards for Medical Laboratories by the Irish National Accreditation Board (INAB) in October 2012. Due to a change in statutory regulation, all departments will be assessed against these standards by INAB in October 2013. • New Blood Gas Analysers: • The Biochemistry laboratory recently completed validation of two new Gem Premier 4000 blood gas analysers, one in the laboratory and one at point of care in the ICU. These instruments provide quantitative measurements for pH, pCO2, pO2, sodium, potassium, chloride, ionised calcium, glucose, lactate, haematocrit, total haemoglobin, oxyhaemoglobin, carboxyhaemoglobin, methaemoglobin and reduced haemoglobin. These parameters, along with derived values, aid in the diagnosis of a patient’s acid/base status, oxygen delivery capacity, electrolyte and metabolite balance. • User Manual: • The current User Manual (Edition 6, June 2012) is available on the hospital intranet under the Pathology pages and also the internet: www.cuh.ie/index.php?id=69 • In order to enable more frequent updates, future editions of the User Manual will only be available via the hospital intranet and internet. • The next phase of implementation will involve interfacing the Gem Premier 4000 analyser in ICU to ICIP. This is currently being initiated and will allow direct automatic transfer of results to the ICIP system and will eliminate manual result entry. • GP Phlebotomy services: • Please advice parents and guardians that they must accompany children during collection and prepare them for the blood test. Phlebotomists use local anesthetic spray and will only try twice to obtain blood. • Please note the following hours of operation: • Monday: AM No service for GP referrals, PM 14:00 to 16:15 • Tuesday to Friday: AM 09:00 to 13:00, PM 14:00 to 16:15 • Haemoglobin & MCHC units: • From 5th June, the reporting reference units for Hb & MCHC will change from g/dl to g/l. This applies to Hb results from the Haematology laboratory and Blood Gas Analysers. • Quick requests: • On-call service users are reminded that this is for emergency samples only. Non-emergency samples should not be sent. • Please use the correct form wherever possible, advice is available from the individual laboratories or Specimen Dispatch. • The cut-off for viral PCR requests sent to the National Virus Reference Lab (e.g. EBV, CMV) is 3pm Monday to Friday. • Samples for Catecholamines must be received by Specimen Dispatch within 30 minutes of collection. • Please ensure that patient labels used on request forms print correctly and a complete set of demographics are included. What would you like to see in your newsletter? Please contact us with queries or requests. Next edition: December 2013 Contact details: (external users, for a direct line please prefix the extension number with: 01 878) Results/General Enquiries: Pathology Office Ext. 4266 Clinical Director: Dr Robert Cunney Ext. 4693 robert.cunney@cuh.ie Laboratory Manager: Mr Martin Stearn Ext. 4364 martin.stearn@cuh.ie Quality Manager: Ms Darina Merlehan Ext. 4588 darina.merlehan@cuh.ie Do we have your up to date details? Please email any changes to the Quality Manager Temple Street Children’s University Hospital Department of Clinical Pathology Newsletter. Edition 1, May 2013. UI/2013/001 P Please consider the environment before printing