Transportation Information and Courses from MediaLab, Inc.

In order to ensure proper stability of the specimen and accurate test results, there are guidelines in place to aid in the appropriate urine processing and transportation. These guidelines include: Ensuring that all urine collection and/or transport containers should be clean and free of debris or interfering substances.Ensuring that the collection and/or transport container has a secure lid and is leak resistant. Leak-resistant containers reduce specimen loss and healthcare worker exposure to the specimen while also protecting the specimen from contaminants.Utilizing urine containers that are made of break-resistant plastic instead of glass.Utilizing urine containers that do not leach interfering substances into the specimen.Utilizing collection containers and/or transport tubes which will not leak within the pneumatic tube system (if one is used within the laboratory facility). A leak-proof device in this situation is paramount.Proper labeling and correct identification should be applied to the collection container or tubes. This includes noting the time the specimen was collected. Remember that urinalysis specimens must be analyzed within 2 hours of collection.Ensuring that there is sufficient volume to fill the tubes and/or perform the test.

For monitored collections, the Department of Transportation classifies the following as health professionals: Physician Medical Technologist Medical Laboratory Technician Nurse (RN/LPN) Physician's Assistant/Nurse Practitioner Medical Technician (A medical technician is anyone who is licensed or certified to practice in the institution where the collection is being done. For example, a phlebotomist, EMT, or medical assistant.)

The Non-Federally Regulated Custody and Control Form is most often used in clinics and hospital emergency rooms when drug abuse is suspected, or by companies participating in their state's drug-free workplace program. Be aware that some states mandate the use of a special CCF for their drug-free workplace program. There are significant differences between the Federally Regulated CCF and the Non-Regulated CCF. You are strongly encouraged to review the difference between the two. Unless there are extenuating (which we will discuss next), remember that the two forms are not interchangeable. The Federally Regulated CCF can be used only for urine collections required by the Department of Transportation drug testing program.

This program is intended to provide guidance and training to those individuals who will be conducting both Department of Transportation (DOT) and Department of Health and Human Resources (HHS) regulated urine specimen collections. While this program is more than just an overview, obvious restraints prohibit an in-depth discussion of every procedure or problem that might be encountered. This program only serves as a training program. It does not represent final authority. Every effort has been taken to keep this course up-to-date with current regulations. However, if anything in this program conflicts with the Urine Specimen Collection Guidelines, U.S. Dept. of Transportation, Office of Drug and Alcohol Policy and Compliance (Aug. 31, 2009), that reference prevails and must be followed.Training to qualify as a drug screen collector must include the flawless completion of five mock collections. These mock collections must include the following scenarios and must be performed in the presence of a qualified collector: Two uneventful collections. One collection in which the quantity of specimen is not sufficient. One collection in which the temperature of the specimen is out of range. One collection in which the donor refuses to sign either the donor certification on the Medical Review Officer's (pink) copy of the CCF or refuses to initial the security strips.

Fortunately, the great majority of collections are uneventful, but from time to time problems or the unexpected occur. This section will discuss a few examples of special situations that may take place during a collection and what the response of the collector should be. Obviously, not every special situation can be envisioned or discussed. It is strongly recommended that the collector be very familiar with the Department of Transportation publication: Urine Specimen Collection Guidelines dated October 1, 2010.

Have and practice a household disaster plan. Be familiar with the Homeland Security Advisory System. Establish meeting places and phone numbers in case   household members are separated. Identify an out of state contact to call during a major disaster or emergency. Prepare and keep up to date disaster supply kits for your home and vehicle. Teach all members of the household when, where, and how to turn off utilities. Have any necessary tools handy. If you have children in school, make sure you understand the emergency plans and expectations at the school. Preplan alternate transportation routes to important destinations. Keep at least a half-tank of gas in your vehicle at all times. Remember, gas stations rely on electricity to power their pumps.            Know ahead of time what you should do to help family, friends, or neighbors who are elderly or have special needs. Make sure you’re dealing with credible sources before providing credit card numbers, social security numbers and other personal information to people or organizations on the internet. Use anti-virus software and regularly download security protection updates.

Medical errors also occur in the analytic processes and systems of patient care. Analytic errors begin with problems in the transportation of medical samples for testing. These occur between the patient's location and the testing facility. They happen during the time between specimen collection and arrival in the testing facility. The possibility for analytic medical error continues through the analytic processes and procedures of medical testing. Analytic medical error also includes systems, processes, and procedures involved in the transmission and reporting of test results. These medical errors occur during the time the laboratory is directly involved in receiving, analyzing, and reporting test samples. Examples: Wrong transport storage or temperature Delay in transport Sample mixup during transport Acceptance of unacceptable samples that are insufficient, hemolyzed, or clotted Centrifugation, mixing, and other test sample preparation errors Wrong test procedures Test control errors Sample mixup during testing Outdated reagents Wrong reagents Test result mixup Transcription errors Data reporting process errors Result report delays

Training records must include:Employee name Most recent date trained Description of training Description, copy, or location of training materials Name and address of trainerThese records must be maintained throughout employment and 90 days thereafter, according to the US Department of Transportation (DOT). IATA requires repeat training every two years. DOT requires training every three years. Laboratory accrediting agencies require training at the frequency appropriate to the specimen types and distance transported. You will be able to print a certificate when you have completed this course that will certify your completion of training for packaging and shipping Division 6.2 (infectious) materials.

Hazardous material classifications are consistent across all agencies who regulate commercial shipping and are based on criteria developed by the United Nations (UN) Committee of Experts working with the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), medical professionals, microbiologists, transportation professionals, and packaging technical experts. These requirements can be found in the 13th and 14th editions of the United Nations Recommendations for the Transport of Dangerous Goods, the 2005 - 2006 edition of the International Civil Aviation Organization Technical Instructions for the Safe Transport of Dangerous Goods by Air (ICAO Technical Instructions), and the International Maritime Organization (IMO) Dangerous Goods Code. The classification system for Division 6.2 Infectious Substances includes two catergories, known simply as Category A and Category B.

International Air Transport Association. Guidance document: Dangerous Goods Regulations (DGR). 52nd ed. 2011.National Laboratory Training Network. Packaging and shipping Division 6.2 materials. Georgia Public Health Laboratory; 2011. Sentinel laboratory guidelines for suspected agents of bioterrorism: Clinical laboratory bioterrorism readiness plan. Available at: http://stanfordhospital.org/PDF/bioterrorism/labGuidelinesSuspectedAgentsBT.pdf. Accessed January 31, 2011.US Department of Transportation Pipeline and Hazardous Materials Safety Administration. Transporting Infectious Substances Safely. Available at http://www.phmsa.dot.gov/staticfiles/PHMSA/DownloadableFiles/Files/Transporting_Infectious_Substances_brochure.pdf.

There are many reasons why certain agents would be selected for use in bioterrorist attacks, including the:Ease of availability: Biological pathogens can be obtained from nature, hospital laboratories, and university research facilities. Difficulty to detect: Small quantities can have potentially deadly or incapacitating effects on a susceptible population. Covert use of the agent: Can be spread throughout large areas by natural convection, air, or water currents. Ease in disseminating: Pathogens can be spread through ventilation systems in buildings. Transportation facilities could become part of the dissemination system by carrying biological agents far from their initial source. Psychological impact: Biological WMD’s could possibly have a psychological impact that will go far beyond their actual effect. The very thought of exposure to a biological agent may possibly cause many people to panic. Ability to tie up resources: Some biological agents can be a hazard for lengthy periods. The use of these agents may require tedious, time-consuming, resource-intensive decontamination and monitoring of facilities before they can be returned to service. Difficulty to defend against attack: It is very difficult for civilian government agencies to prepare for biological terrorist incidents. While most civilian agencies have some kind of hazardous material or HAZMAT response teams; in the event of a biological terrorist incident, these teams are likely to be challenged beyond their capability in terms of human resources, and equipment.

Quality control (QC) is a system used to maintain a determined level of accuracy and precision. Proper quality control helps ensure that reported results of patient laboratory testing are correct. Quality control applies not only to specimen testing, but also to collection, storage, and transportation.

Some starch granules from dusting powders have faint concentric striations, others do not. External contaminants (ie, those that enter the urine specimen during collection, transportation, or while being examined on the slide) must be differentiated from crystals and other clinically significant findings.