Investigations

Requesting Investigations

Bloods

All routine blood requests should be made on ICE (see IT section of handbook for advice on how to do this).

Urgent bloods, for example taken in an arrest situation, should be highlighted as urgent by selecting this option on the ICE request. If using the pod, phone the lab to make them aware that the bloods are being sent or ask a member of staff to walk the bloods to the lab.

If bloods are to be taken in the future, for example the next day or over the weekend, the date can be changed on the request and most wards will have a folder/box to place the stickers in.

If you have been asked to do an unfamiliar blood test and are unable to find it on ICE, phone the relevant laboratory (bichem, haematology, microbiology, histology) as the request may need to be made on a paper request form. These are usually available on most wards.

Additional blood tests for biochemistry and virology can be added on via the staff messaging facility (IntranetàStaff Messaging Facilities Add-On Tests online Request Form) and the tests will be added to the sample already in the lab. To add tests for haematology and coagulation it is necessary to ring the labs.

For blood products a Group and Save sample must be requested on a paper form, not via ICE. If the patient has never had a Group and Save sample taken before then you must send two samples taken at two different times. Once a Group and Save is sent it is valid for up to 72 hours if they’ve had a transfusion before, or up to a week if they have not.

Radiology

All routine radiology requests should be made on ICE (see IT section of handbook for advice on how to do this). Depending on the investigation requested, some may need to be discussed with radiology by a senior doctor, or authorised by a speciality doctor.

If your request is urgent, or if it is out of hours and you are requesting anything except X-rays and some CT head scans (e.g. for an unwitnessed fall or low GCS), it should be discussed with the duty radiologist. When requesting urgent imaging out of hours it is best to call the radiology department as well as making an ICE referral.

Endoscopy

Inpatient endoscopy requests should be made on ICE (see IT section of handbook for advice on how to do this).

Outpatient requests are on a paper form which should be taken to the department or emailed to sth.endoscopyadmintasks@nhs.net. It is good practice to document on the top of the form the date and time the form was emailed before filing in the notes.

Please ensure that bowel prep is prescribed if required.

Cardiology

Most cardiology requests are made on ICE (see IT section of handbook for advice on how to do this). This includes 24 hour ECGs, echocardiograms and pacemaker interrogation.

Vascular Radiology

Requests for vascular radiology investigations are made via a consultant to consultant referral through switchboard.

Viewing Investigation Results

Bloods

Results will be displayed on ICE once processed and authorised. If there is a significant delay, phone the relevant lab as it might be an indication there is a significant abnormality or the tests will need repeating.

It is possible to see the progress (e.g. when they have been received) by selecting the ‘orders’ screen.

Blood tests should be ‘filed’ once reviewed and actioned. It is possible to see an audit trail on ICE.

Radiology

Images and reports can be viewed on PACS (see IT section of handbook for advice on how to do this). Provisional reports made out of hours will be available to view on PACS under the ‘comments’ section.

Finalised imaging reports are viewed on ICE but it can take some time for these to become available out of hours.

Endoscopy

Reports can be viewed on Infoflex:

1.      Select the relevant service from the menu in top left (eg cardiology, endoscopy)
2.      Click in one of the boxes for patient information at the top of the main screen (eg under Patient ID)
3.      A search box will appear, enter the hospital number in the top box and click search
4.      Select the relevant investigation from the list on the left
5.      The report will appear on the main part of the screen

Cardiology

Echocardiography reports can be viewed on Infoflex:

1.      Select the relevant service from the menu in top left (eg cardiology, endoscopy)
2.      Click in one of the boxes for patient information at the top of the main screen (eg under Patient ID)
3.      A search box will appear, enter the hospital number in the top box and click search
4.      Select the relevant investigation from the list on the left
5.      The report will appear on the main part of the screen

24 hour ECG results should be filed in the patients notes.