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Minimum Dataset for Completing Request Forms

COMPLETING REQUEST FORMS

Requests from within the Trust and from General Practices for Microbiology Specimens.

SPECIALIST INFORMATION IS REQUIRED FOR ANDROLOGY, ANTIVIRAL RESISTANCE TESTING AND OUTBREAK TESTING. PLEASE PHONE THE LAB FOR MORE DETAILS: 0121 424 3256

The tables below indicate the essential data required on samples and request forms and outlines the desirable information which ideally should also be included.

 

Essential

 

Desirable

 

Request Form

 

1. Full name or coded identifier

 

2.PID or NHS number or date of birth

 

3.Location or destination for report

 

4.Consultant or General Practitioner

5.Specimen type

6.Test required

7. MUST be signed and dated by person collecting sample

1. Other information listed under essential if not used as an essential option.

2.Clinical information

 

3.Date and time sample collected (becomes essential when time factors affect test results)

 

4.Patient's address

 

5.Patient's sex

 

6.Practitioner's bleep number

 

7.Name of requesting practitioner

 

Specimen

1. Full name or coded identifier whichever is given on form

2.PID, NHS number or date of birth whichever is given on form

 

1. Other information listed under essential if not used as an essential option

2.Date and time taken

 

3.Destination for report

 

Requests from Other Hospitals for Microbiology Specimens.

 

SPECIALIST INFORMATION IS REQUIRED FOR ANDROLOGY, ANTIVIRAL RESISTANCE TESTING AND OUTBREAK TESTING. PLEASE PHONE THE LAB FOR MORE DETAILS: 0121 424 3256

 

The tables below indicate the essential data required on samples and request forms and outlines the desirable information which ideally should also be included.

 

Essential

 

Desirable

 

Request Form

1 identifier from each of 2 of the 3 sets listed below.

 

 

1. Name or coded identifier

2.PID, NHS number or date of birth

 

3.Requesting laboratory number

 

4.Location or destination for report

5.Specimen type

6.Test required

1. Other information listed under essential if not used as an essential option

2.Clinical information

 

3.Date and time sample collected (becomes essential when time factors affect test result)

 

4.Patient's address

 

5.Patient's sex

 

6.Name of requesting practitioner/ department

 

Specimen

 

1 identifier from each of 2 of the 3 sets listed below

and also stated on the request form.

 

 

1. Full Name or Coded identifier

2. PID or NHS number or date of birth

 

3.Requesting laboratory number

 

1. Other information listed under essential if not used as an essential option

2.Date and time taken

 

3. Destination for report

 

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