**Procedure for informing patients and users about the laboratory services ** ===Header=== ^Name^Unique ID^ Edition/Date of Edition ^ |Procedure for informing patients and users about the laboratory services|nchsls:c:Cytopathology:document:06| 03-01-2015| ^Preparing authority^Approving authority^Review period^ |All teaching staff of Pathology Department |In-charge Cytopathology|1 year| |Controlled copy of this document exist in electronic form at IP address 10.207.3.240 of LAN at NCH, Surat| |**Printed copy of this document with signature of authorized person is to be considered controlled.** | ===1.The location of the laboratory=== -Body fluid and Intraoperative cytology at the Cytopathology Laboratory, 3rd floor, College Building between 9 AM to 5 PM. -Fine Needle Aspiration (FNA) and cervical PAP- OPD hours: 9 AM to 1 PM and 4 PM to 6 PM ===2.List of examinations under scope of Cytopathology Section=== ^Sr^Specific tests/ examination performed^ ^ ^ |1|Fine needle aspiration material|Cytology smear|H & E, MGG, PAP Stain| |2|Body fluids|Cytology smear|H & E, MGG, PAP Stain| |3|Sputum|Cytology smear|H & E, MGG, PAP Stain| |4|Cervical/ PAP smear|Cytology smear|PAP stain| ===3.Opening hours of laboratories=== -**For Fine needle aspiration sample collection room OPD - 10** -Monday to Friday : 9 AM to 1 PM and 4 PM to 6 PM -Saturday : 9 AM to 1PM -**For Cytopathology laboratory** -Monday to Friday : 9 AM to 5 PM -Saturday : 9 AM to 1PM ===4.The examinations offered by the laboratory=== **Type and amount of sample to be collected** ^Sr^Specific test/examination performed^Material for examination^Sample storage container^Type & amount of sample |1|Fine needle aspirated material|Cytology smear|Slides |4 slides| |2| Body fluid|Cytology smear|EDTA/ Heparin Vacutainer|4 ml| |3|Sputum|Cytology smear|Plastic container|4-5 ml| |4|Cervical / PAP Smear|Cytology smear|Slides|2slides- Ectocervical&Endocervical| |5|Intra-operative FNA|Cytology smear |Slides|4 slides| **Special timing of collection** ^Sr^Specific test/examination performed^Special timing of collection^Special precaution^Turn Around Time (TAT)^ |1|Fine needle aspirated material|Any time between 9 am – 1 pm and 4 pm – 6 pm| |<3 working days| |2|Body fluid|Any time. ( 9 am – 5 pm)|Within 2 hours of collection|<3 working days| |3|Sputum|Early morning sample|Within 2 hours of collection|<3 working days| |4|Cervical / PAP Smear|After 10 to 20days of menstruation| |<3 working days| |5|Urine|Initial morning sample to be discarded|Within 2 hours of collection|<3 working days| |6|Intra operative FNA|9 am – 5 pm| |30 minutes| ===5.Instructions for completion of the request form=== -Five most essential items on request form: MRD + Name + Department + Unit + Ward -MRD number is most important item in filling request form. -Do not forget to write correct name. It is very useful to identify patient when any thing goes wrong with MRD number provided. -[Department + Unit + Ward ] help to locate patient for conveying critical reports. Please mention them without fail. -This is a no-fee, nominal-fee laboratory.Please request only necessary examinations. -Do not forget to write relevant clinical history, any investigations, past history, previous history of FNAC reports if any, the source of material is important for proper evaluation of reports. -Swelling should be marked by clinician when it is not assessable ===6.Instructions for preparation of the patient=== -A clear explanation of the procedure. -Explain procedure and possible side effects. -Take informed consent -The procedure is carried out in supine position on a simple examination couch or a chair with head rest for aspiration from head & neck area. -Local Anesthesia is given by clinician in deep seated lesion are to be aspirated with aid of CT or USG ===7.Consent form for FNA=== {{:nchsls:c:cytopathology:document:whatsapp_image_2022-01-24_at_18.27.57.jpeg?400|}} {{:nchsls:c:cytopathology:document:whatsapp_image_2022-01-24_at_18.26.36.jpeg?400|}} {{:nchsls:c:cytopathology:document:whatsapp_image_2022-01-24_at_16.39.47.jpeg?400|}} ===8.The laboratories criteria for accepting and rejecting samples=== -Cytopathology sample are not rejected on the basis of poor sample integrity. They are all accessioned and appropriate remarks the incorporate in the gross, microscopic descriptions and diagnostic interpretations. -In case of any discrepancy of sample identification and traceability or sample misleading, the sample is not processed for examination till relevant information are obtained. Meanwhile concerned clinician is informed and necessary correction are made. In the intervening period, the sample is not discard. ===9.A list of factors known to significantly affect the performance of examination or the interpretation of the results== -If the swelling is small and difficult to aspirate, adequate material may not to be obtained. -Aspirated material may be not representative of the whole swelling which may lead to false or negative diagnosis. -Inadequate clinical information may lead to difficulty in interpretation. -Insufficient quantity of fluid may lead to false negative interpretation. -Time of receipt of sample is more than recommended time may lead to poorly preserved cytomorphology leading to difficulty in interpretation. ===10.Availability of clinical advice on ordering of examinations and on interpretation of examination results=== -Specimen of fluid should be submitted to the laboratory as early as possible within 2 hours of collection. Patient selection: -In patient with clotting disorders deep seated lesions should not be aspirated. **While taking Pap smear** -Women should not use any vaginal medication, contraceptives during the 48 hours prior to the sample collection. -Mucous or any other discharge from the cervix should be gently removed by a folded gauze pad. -The cervix should not be cleaned by washing with saline as it may result in a relatively acellular sample. -Wet smears should immediately be fixed without delay **Contraindications of FNAC** -Carotid body tumors -Pheochromocytomas -Highly vascular tumors -Hemangiomas -Prostatitis -Ovarian cyst aspiration -Hydatid cysts -Lung lesions like severe emphysema, pulmonary hypertension-condition associated with severe hypoxaemia. ===11.The laboratory’s policy on protection of personal information=== The laboratory gives patient sample report to -Authorized report collection person -Patient and their relatives -Authorized person from ward/Residents/Interns The laboratory use laboratory data for research only after striping data from patient identification. ===12.Complaints and suggestions=== ^**The laboratory welcomes complaints and suggestions. The laboratory provides feedback to any complaint made by you.**^^ ^Method^Details^ |Phone|0261-2208410, 0261-2208411| |Oral|Clinicians are encourages to convey their feedback at various meetings. Patients and their representatives can make oral complaint to any personnel of NCHSLS. Download feedback form{{:nchsls:c:histopathology:document:feed_back_format.doc |}}| |Email| | |Written complaints to NCHSLS|On simple paper or feedback form, deposit complaint to any personnel of NCHSLS, Ask for acknowledgement. download feedback form |