Work flow - Biochemistry

Sample received

Proceed as per
Process the sample Test done
No Yes individual test
for outsourcing in-house ?
procedure

Check instrument
Fill up requisition readiness and
form acceptability of
Internal QC results

Dispatch the Load sample on

specimen to outside instrument and start
lab analysis

Result Scanned and Lab tech repeats test

saved to patient if required and
records . verifies results ,
submits for validation

Photo copy of result Pathologist requests

filed in lab and for repeat test if
original report required and / or
dispatched . Validates results

Report available
 Work flow – Hematology

Specimen

Proceed as per
Process the sample for Test done in
No Yes individual test
Outsourcing House ?
procedure

Check instrument
readiness and
Fill up requisition form
acceptability of internal
QC result

Load sample on
Dispatch the specimen
analyzer or perform
to outside lab
test manually

Result scanned and Lab tech repeat test if

required and verifies
saved to patient
records results and sends for
validation

Photo copy of result Pathologist requests

for repeat test if
filled in lab and original
required and / or
report dispatched
validates results

Report released
Work flow – Clinical Pathology flow

Sample received

Process the Process as per

Test done in-
sample for No Yes individual test
house ?
outsourcing procedure

Check instrument
Fill up the readiness and
requisition form acceptibility of
internal QC results

Load individual
strip and analyze
Dispatch the and study
specimen for centrifuged deposit
outside lab under microscope

Lab tech repeat

test if required
Result scanned manually and
and saved to verifies the results
patient records and send for
validation

Pathologist
Photo copy of
requests for repeat
result filled in
test if required
lab and original
and/ or validates
report
results
dispatched

Report available

Microbiology
 Sample received

Process the Process as per

Test done
sample for No Yes individual test
in-house ?
outsourcing procedure

If done using
instruments
check for
Fill up requisition readiness and
form acceptability of
internal QC
result

Load sample on
Dispatch the
instrument or if
specimen to
manual , proceed
outside lab
as per procedure

Organism
Result scanned identified and
Growth
and saved to antibiotic Yes
observed ?
patient records susceptibility
tested

No

Photo copy of
the result filed in
lab and original Result verified
report and validated
dispatched

Report available

# Specimen Media used

 1 Urine CLED
BA, MA, XLD, DCA, LCA, TCBS,
Selenite F broth, Alkaline peptone
2 Stool water
3 Pus BA, MA, Thioglycolate broth
4 Sputum, BA, MA, CA
5 Throat swab BA, MA, CA
6 Vaginal Swab BA, MA, CA, GCA
7 Blood BacT/ ALERT 3D bottle, BA, MA
8 CSF BA, MA, CA, Thioglycolate broth
9 Fluid BA, MA, CA, Thioglycolate broth
10 Semen BA, MA, CA, GCA
11 MRSA Screening Mannitol salt agar
12 Endotracheal secretion BA, MA, CA
13 Bronchoalveolar lavage BA, MA, CA
14 Intravascular line tips BA, MA, Thioglycolate broth
15 Fungal culture Sabourauds agar
MacConkey broth purple (100 ml per
16 Water culture test )
Environmental surveillance
17 swabs BA, MA, Thioglycolate broth
18 Ear Swab BA, CA, MA

Infection control surveillance cultures

Ensuring that air quality as well as surface cleaning is maintained in operation theaters
and other critical care units (ICU’s) is an essential component of any infection control
program. As part of ongoing surveillance in the hospital, routinely air cultures are done
using settle plate method following air disinfection in OT’s and ICU’s. Also, surface
cleaning is checked by culturing swabs from different critical surfaces in both OT’s And
ICU’s.
Surveillance cultures are processed in the microbiology lab to look for presence of any
dangerous pathogens in them and also to look for any increase in contamination levels
which would indicate a breakdown in the sterility barrier in these areas. Each such
breach should be investigated and corrective and preventive action is taken.

Method:
• Incubate air culture plates at 37 + 2degC for 24hours. Streak swabs on ¼ blood agar
plate and

• incubate at 37 + 2degC for 24 hours. Read plates next day and observe colony
counts. Look for

• presence of dangerous pathogens like Staphylococcus aureus, Pseudomonas

aeruginosa, Fungi etc and report as such.
 Interpretation:
• Dangerous Pathogens:
o Staphylococcus aureus

o Pseudomonas aeruginosa

o Streptococcus pyogenes

o Aspergillus species

• If isolated these should be reported and the infection control team alerted. Other
bacteria like coagulase negative Staphylococci and Diphtheroids should be
designated as No Pathogen Isolated.

• Colony counts < 5 are considered acceptable. If colony count > 5 are seen, cleaning
and/or air disinfection should be repeated followed by microbiological sampling.

Serology
 Sample received

Process the
Test done
sample for No
In - house ?
outsourcing

Yes

Process as per
Fill up requisition Stat Test ? No individual test
form procedure

If done using
instruments
Dispatch the check for
specimen to readiness and
outside lab acceptability of
internal QC
result
Yes

Result scanned Load sample on

and saved to instrument or if
patient records manual proceed
as per procedure

Photo copy of
the result filed in Performtest by Result verified
lab and original Rapid method and validated
report
dispatched

Report available
Work flow - Histopathology

Samplereceived

Preparefor Frozen Preparefrozen

No Yes
grossing section ? sections

Grossingby Processtissue Prepareparaffin

pathologist bits sections

Dospecial Special stain Stainthe

Yes
staining required ? sections

No

Pathologist Deeper Cut deeper

report the No section Yes sectionandstain
findings required ? asrequired

Second
Obtainsecond
Yes opinion
opinion
required ?

No

Result updated
inLIM S

Report available
 Cytology
Specimen
received

Verify against
order details

Conduct physical
examination

Conduct
chemical
examination

Conduct
microscopic
examination

Result Reported