Clinical Diagnostic Laboratory

The Clinical Diagnostic Laboratory provides a wide range of highly specialized diagnostic services. «Requirements for quality and competence», which confirm: guaranteed quality and reliability of studies obtained by the laboratory, recognition of study results obtained in our laboratory abroad, official recognition of the competence of the Medical Center Hospital laboratory at the national and international levels, maintaining the level of competence through regular inspections. The MCH CDL is in the register of accredited laboratories on the website of the National Accreditation Centre LLP. The Clinical Diagnostic Laboratory today is a high-tech department: equipped with instrumentation from world-leading manufacturers - BIO-RAD, BD Biosciences, Roche Diagnostics, Sebia (USA, Germany, Netherlands, Austria).

Patients can be sure of the correctness and reliability of the results obtained. The guarantee of quality and reliability of laboratory test results is:

· Participation of the Clinical Diagnostic Laboratory in the international quality assessment system (EQAS-USA, RIQAS-UK, FSVOK-RF)

· Ensuring the internal quality control system

· Conducting research on high-tech modern equipment from Abbott, Siemens, Bio-Rad, Tecan, Becton Dickinson & Co, Sysmex Corporation, BioMerieux

· Highly qualified personnel

· Use of disposable sterile blood collection systems and other biological materials

· Availability of accreditation according to the standard ST RK 15189-2023 "Medical laboratories. Requirements for quality and competence".

· Guaranteed quality and reliability of studies obtained by the laboratory

· Recognition of test results obtained in our laboratory abroad

· Official recognition of the competence of the BMC laboratory at the national and international levels

· Maintaining the level of competence through regular inspections.

The MCH CDL is in the register of accredited laboratories on the website of the National Accreditation Centre LLP.

Laboratory Services

The list of services performed reaches about 1000 items. In our work, we use the following methods:

· Flow cytometry

· Enzyme-linked immunosorbent assay (ELISA)

· Hematology

· Biochemistry

· Hemostasis studies

· Polymerase chain reaction (PCR)

· Immunofluorescence

· Serological studies

· Bacteriological studies

· Parasitological studies

· Molecular genetic studies

REMINDER FOR THE PATIENT WHEN PREPARING FOR A BLOOD TEST

Complete Blood Count

To obtain accurate diagnostic data in the results of laboratory analysis, it is necessary to follow several rules before taking the test:

· Blood should be taken from a vein for testing between 8 and 10 am on an empty stomach, that is, the patient does not eat food after a regular dinner until blood is drawn.

· Juice, tea, and coffee should also be excluded.

· Water can be drunk.

· On the eve of the blood test, you should not eat food with a high fat content.

On the eve of the test, it is necessary to:

· Eliminate the consumption of food with a high fat content.

· Eliminate physical exertion and emotional stress.

· Avoid any stressful situations.

· Eliminate alcohol consumption and smoking.

· Eliminate the intake of medications, or if undergoing inpatient treatment, blood should be drawn for testing before taking medications.

· Physiotherapeutic procedures, as well as X-ray, ultrasound and rectal examinations, are performed after blood sampling for analysis, since exposure to low-frequency or high-frequency radiation can change hematological blood parameters (decrease in leukocyte and hemoglobin concentrations).

Biochemical Blood Test

To obtain accurate diagnostic data in the results of biochemical analysis, it is necessary to follow several rules before taking the test:

· Blood for testing is taken after 8-14 hours of fasting and abstinence from alcohol, in the morning hours (between 8 and 11 am), with minimal physical and emotional activity immediately before collection (20-30 minutes), in a lying or sitting position

· It is necessary to refrain from smoking for 2 hours before blood collection

· In case of an urgent need to collect the material at another time of day, the time period that has passed since the last meal must be indicated

· Collection of material for the test must be carried out before performing a therapeutic prescription (taking medications, injections, physical methods of treatment: UHF, microwave) or diagnostic (X-ray, ultrasound, endoscopic) procedures.

Biochemical Urine Test

To obtain the most accurate and reliable results when collecting urine, the following requirements must be met:

· Exclude the use of diuretics 48 hours before urine collection (consult with your attending physician)

· 24 hours before the test, exclude spicy, salty foods from the diet, as well as foods that change the color of urine (beets, carrots)

· Exclude physical and emotional overexertion 24 hours before the test

· Urine collection is carried out after hygiene of the external genitalia

· For testing, the middle portion of morning urine or urine collected during the day is used.

24-Hour Urine Collection

· Urine is collected during the day: the first morning portion of urine is discarded, all subsequent portions of urine excreted during the day, night, and the morning portion of the next day are collected in one container, which is stored in the refrigerator (+4 to +8°C) throughout the entire collection period

· After completion of urine collection, the contents of the container should be accurately measured, be sure to mix, and immediately pour into a sterile container, which must be purchased in advance at any pharmacy

· Bring this container to the laboratory for testing

· There is no need to bring all the urine

· You must indicate the daily urine volume (diuresis) in milliliters, for example: "Diuresis 1250 ml".

Coagulological Blood Test

To obtain accurate diagnostic data in the results of biochemical analysis, it is necessary to follow several rules before taking the test:

· Do not eat for 12 hours before blood collection

· Avoid physical exertion, alcohol consumption, and fatty foods 1 day before blood collection

· Exclude coffee, alcohol, and garlic from food 24 hours in advance

· Refrain from smoking for 2 hours before blood collection

· If possible, stop taking medications 1 day before blood collection (in consultation with your attending physician)

· Before blood collection, it is necessary to inform the physician about taking anticoagulant medications

· Anticoagulant medications should be taken only after the blood collection procedure.

Platelet Aggregation

· A week before blood collection, in consultation with the attending physician, all aspirin-type drugs, Indomethacin, Sulfapyridazine, and antidepressants must be discontinued

· If it is impossible to stop taking them, this must be reported

· Do not eat for 12 hours before blood collection

· Exclude physical and emotional overexertion 30 minutes before the test

· Exclude coffee, alcohol, and garlic from food 24 hours in advance

· Refrain from smoking.

Determination of Lupus Anticoagulant

· Do not eat for 3-4 hours before blood collection

· Exclude physical and emotional overexertion 30 minutes before the test

· Stop taking heparin and its analogues 5 days before the test (in consultation with the attending physician).

Glucose Tolerance Test

· One week before the test, the diet and eating regimen do not change

· The amount of carbohydrates in food should be at least 125 g per day for 3 days before blood collection (the diet is agreed upon with the physician)

· Nothing should be eaten for 12 hours before the start of the test, but in no case should fasting last more than 16 hours

· Exclude physical activity for 12 hours before the start of the test

· Blood for glucose is taken in the morning on an empty stomach, then a glucose solution is drunk (the concentration of the solution and volume are prescribed by the physician)

· Blood is then taken for testing 1 and 2 hours after taking the glucose solution.

REMINDER FOR THE PATIENT FOR URINE COLLECTION TESTING

General Urinalysis

· Urine collected in a volume of less than 7 ml is not accepted for testing

· On the eve of the test, it is recommended not to consume vegetables and fruits that may change the color of urine (beets, carrots), and not to take diuretics

· Before collecting urine, perform a thorough hygienic cleansing of the genitalia

· Collect approximately 50 ml of morning urine in a container

· During the first morning urination, release a small amount of urine (the first 1-2 seconds) into the toilet, and then, without interrupting urination, place the container for urine collection and collect approximately 50 ml of urine

· Women are not recommended to take a urine test during menstruation

· Immediately after collecting urine, tightly close the container

· The container with urine must be delivered to the laboratory from 08:00 to 10:00.

Urinalysis (Nechiporenko's method)

· Urine collected in a volume of less than 10 ml is not accepted for testing

· Before collecting urine, perform a thorough hygienic cleansing of the genitalia

· During the first morning urination, release a small amount of urine (the first 2-4 seconds) into the toilet, and then, without interrupting urination, place the container for urine collection and collect 10 to 50 ml of urine

· Women are not recommended to take a urine test during menstruation

· Immediately after collecting urine, tightly close the container

· The container with urine must be delivered to the laboratory from 08:00 to 10:00.

Total Protein Test in 24-Hour Urine

· The entire volume of urine is collected over 24 hours. The first morning portion of urine is discarded

· All subsequent portions of urine excreted during the day, night, and the morning portion of the next day are collected in one container, which is stored closed in the refrigerator (+4...+8°C) throughout the entire collection period (this is a necessary condition, since at room temperature the content of the analyte being tested is significantly reduced)

· After completion of urine collection, the entire contents of the container must be delivered to the laboratory from 08:00 to 10:00.

Three-Glass Urine Test

· Before collecting urine, perform a thorough hygienic cleansing of the genitalia

· Women are not recommended to take a urine test during menstruation

· Number the urine collection containers 1, 2, 3. On the count of 1-2 (1/5 of the total urine), collect in container No. 1, on the count of 3-7 (3/5 of the total urine, collect in container No. 2), and the remaining urine in container No. 3

· Immediately after collecting urine, tightly close the containers

· Deliver the containers with urine to the laboratory from 08:00 to 10:00.

Urinalysis (Zimnitsky’s method)

· During the test, it is not recommended to consume more than 1-1.5 liters of water or various beverages

· Record the amount of liquid drunk

· At 6 am, empty your bladder, urine does not need to be collected

· Then, from 9 am, urine portions are collected in the amount of 8 pieces

· from 9 am to 12 pm - portion No. 1

· from 12 pm to 3 pm - portion No. 2

· from 3 pm to 6 pm - portion No. 3

· from 6 pm to 9 pm - portion No. 4

· from 9 pm to 12 am - portion No. 5

· from 12 am to 3 am - portion No. 6

· from 3 am to 6 am - portion No. 7

· from 6 am to 9 am - portion No. 8

· During the specified time intervals, if there are several urges to urinate, collect all the urine in a container with the corresponding marked time interval

· Nothing should be poured into the toilet

· If a specific container is overfilled, an additional container is taken, and the corresponding time interval is indicated on it

· If during a certain interval you have no urge to urinate, leave the container empty and send it in that form

· The container with urine must be delivered to the laboratory from 08:00 to 10:00.

24-Hour Urine Sugar Test

· At 8 am, empty your bladder into the toilet and then, until 8 am the next day, collect all urine in one container (a three-liter jar)

· Urinate into the jar for the last time at 8 am the next day. Close the container with a lid and submit it to the test reception point along with the referral.

Urine Test for Alpha-Amylase (Diastase)

· In the morning, at the appointed time, thoroughly perform hygiene of the external genitalia, collect 50-100 ml of urine in a container, preferably from the middle portion

· Close the container with a lid and immediately submit it to the test reception point along with the referral.

Urine Test for Bacteriological Examination

· In the morning, thoroughly perform hygiene of the external genitalia and release the first stream of urine on the count of 1, 2 into the toilet, and then collect the middle portion of urine in a sterile container

· Try not to touch the inner surface of the stopper and test tube, place the lid on a clean napkin with the inner surface facing up

· Finish urinating into the toilet

· Submit the collected urine to the designated place.

Urine Test for Microalbumin

· In the morning, after waking up, thoroughly perform hygiene of the external genitalia and collect 50-70 ml of urine from the middle portion of the urine stream

· Close the container with a lid and leave it at the test reception point along with the referral.

Urine Test for Detection of Urogenital Infection Pathogens by PCR

· In the morning, before submitting urine, it is necessary to perform hygiene of the external genitalia in the direction from front to back, with a weak soap solution without the use of antiseptics

· After hygiene procedures, begin urinating into a dry sterile container (without preservative solution) for urine collection

· The first portion of urine is collected, immediately after sleep, in the amount of 10-50 ml

· Do not cool or freeze the urine!

· The sample must be delivered to the laboratory as soon as possible

· The test is not prescribed on days of menstruation

· For monitoring of cure, the examination is recommended to be performed no earlier than 5-6 weeks after the end of treatment.

REMINDER FOR THE PATIENT FOR SPUTUM COLLECTION FOR TESTING

· In the morning, before brushing your teeth (to avoid red blood cells getting into the sputum, as microtrauma is possible when brushing teeth), thoroughly rinse your mouth, then cough into the container

· It is necessary to avoid saliva getting into the container

· The container with sputum must be delivered to the laboratory from 08:00 to 10:00.

Sputum Test for Mycobacterium Tuberculosis

· It is necessary to collect 3 sputum samples over 2 days according to the following schedule

· The first sputum sample is collected under the supervision of a medical professional (first day of testing)

· The second sample should be collected as the morning portion of sputum at home (second day of testing)

· In the presence of a medical professional, it is necessary to collect the third sample (second day of testing, during the day)

· Before collecting material for testing, it is not recommended to smoke, there are no special dietary restrictions, do not chew nuts or seeds (to avoid injury to the oral mucosa)

· Sputum for testing is collected before meals, after rinsing the mouth with warm boiled water, but in the morning you should not brush your teeth with a toothbrush, as this may damage the gum mucosa

· While collecting sputum, take a comfortable position: standing, sitting, or lying on your healthy side

· Sputum is obtained from the deep parts of the bronchial tree as a result of a strong cough

· If sputum is absent or only a small amount is produced, an expectorant should be used or aerosol inhalations that increase bronchial secretion should be performed (the method of stimulating sputum production should be agreed with a physician or nurse)

· So, in the morning, on an empty stomach, brush your teeth and rinse your mouth with water, then take several deep breaths and cough up sputum into a clean, dry container, a total of 15-20 ml

· Tightly close the container with sputum and leave it at the place indicated in the referral.

Sputum Test for Bacteriological Examination

· Brush your teeth and thoroughly rinse your mouth with boiled water before coughing up, then make 2-3 spits of sputum into the jar, trying to prevent saliva from getting in

· The container is sterile, so do not touch its edges with your hands or mouth, and after coughing up sputum, immediately close with the lid and give it to the nurse.

Sputum Test for Atypical Cells

· In the morning, on an empty stomach, before coughing up, brush your teeth and thoroughly rinse your mouth with water

· Then make several spits of sputum into the jar and immediately give it to the nurse.

Sputum Test for Detection of Infectious Agents by PCR

· Sputum should be collected in the morning, before meals

· Before collecting sputum, it is necessary to brush your teeth and rinse your mouth with boiled water

· Saliva and nasal mucus must not enter the sputum

· Sputum is collected in a sterile container, in an amount of at least 0.5 ml

· It is recommended to hold the container as close to the lips as possible, and immediately spit sputum into it as it is coughed up

· Only sputum that is released by coughing should be collected, not by expectoration.

Saliva Test for Detection of Infectious Agents by PCR

· Before saliva collection, the mouth is rinsed three times with boiled water

· Saliva is collected in a sterile vial, in an amount of 3-5 ml

· Saliva should be collected immediately before testing, and immediately delivered to the laboratory.

REMINDER FOR THE PATIENT FOR STOOL COLLECTION FOR TESTING

· Coprogram, fecal occult blood test, stool test for the presence of Helicobacter pylori antigen

· The material (stool) is collected before the start of treatment with antibacterial and chemotherapeutic drugs (if impossible, then only 12 hours after discontinuation of the drug)

· 3-4 days before the test, it is necessary to discontinue the use of laxatives, castor oil and vaseline oil, and stop the administration of rectal suppositories

· Stool obtained after an enema, as well as after taking barium (during X-ray examination) is not used for testing

· By natural defecation into a clean container, collect the feces, preferably from the last portion of stool (make sure that urine does not get in)

· Stool is collected in a clean, disposable container with a screw cap and a spoon in an amount of no more than 1/3 of the container volume

· The material is delivered to the laboratory no later than 3 hours from the time of collection, according to the biomaterial reception schedule (from 08:00 to 10:00)

· Biomaterial delivered in a matchbox or other non-hermetically sealed container (plastic cup, bag) is not accepted for testing

· For stool occult blood testing, a special diet is not required, since the analysis is performed by immunochromatographic method.

Stool Test for the Presence of Helminth Eggs

· Immediately after defecation, use the stick on the lid of the plastic container to take from three areas 30-50 g of stool without impurities of water and urine and place them into the vial

· Close with the lid and leave together with the referral at the designated (specially allocated) place.

Stool Test for the Presence of Protozoa

· Immediately after defecation, use the stick on the lid of the plastic container to take from three areas 5-10 g of stool into the vial

· Close with the lid and immediately submit to the place indicated in the referral.

REMINDER FOR THE PATIENT FOR TAKING A CERVICAL SMEAR FOR ONCOCYTOLOGICAL EXAMINATION

· A cervical smear should be taken no earlier than the 5th day and no later than 5 days before the expected onset of menstruation

· Do not introduce medications, suppositories, creams into the vagina, including creams for performing ultrasound examination

· 24 hours before taking the smear, exclude sexual intercourse.

Reminder for the Patient for Taking a Gynecological Smear for Vaginal Purity Test

· For 2-3 days, do not perform vaginal douching so as not to wash out the flora, do not introduce medications, suppositories, creams into the vagina for a week before the test

· 24 hours before taking the smear, exclude sexual intercourse

· The test is not taken on days of menstruation.

REMINDER FOR THE PATIENT FOR COLLECTION OF BIOMATERIALS FOR GENERAL CLINICAL EXAMINATION

Collection of Material from the Urogenital Tract for Detection of Urogenital Infection Pathogens by PCR

Preparation:

· Before conducting the test, it is necessary to abstain from sexual relations for three days

· On the eve of the examination, exclude hygiene procedures using antiseptic agents, local treatment

· Women should undergo examination before menstruation or 1-2 days after its end, do not douche, stop the administration of any vaginal suppositories

· Before taking the material, it is recommended not to urinate for 2 hours

On the day of the examination:

· Perform hygiene of the external genitalia in the direction from front to back, with a weak soap solution without the use of antiseptics

· It is advisable to undergo examination during the period of infection exacerbation; after at least 3 weeks have passed since unprotected sexual contact

· For monitoring of cure, the examination is recommended to be performed no earlier than 5-6 weeks after the end of treatment.

Microscopic Examination of Eyelashes and Skin Scraping for the Presence of Mites of the Genus Demodex

· It is recommended not to wash with soap for 24 hours before the examination

· 1-3 days before the examination, discontinue the use of creams and ointments.

Microscopic Examination of Biomaterial for Fungi

· It is advisable to perform before the start of treatment, or discontinue the use of creams, ointments, and antifungal agents

· One day before the examination, the use of soap is not recommended.

Spermogram

· Sexual abstinence for 2-7 days is important, preferably 3-5 days

· During this period, you cannot consume alcohol, medications (exception: vital medications prescribed by a physician for permanent use - do not discontinue), visit a bathhouse or sauna, or be exposed to UHF

· If there was an increase in temperature due to illness during this period, the analysis should be postponed

· During repeated testing, it is advisable to establish, if possible, the same periods of abstinence to reduce fluctuations in the obtained result

· Ejaculate is obtained by masturbation into a plastic container

· The use of a condom for sperm collection is prohibited (substances used in the production of condoms may affect the degree of sperm motility)

· If part of the ejaculate was lost during collection, it is necessary to inform the physician and note on the referral which portion was lost (initial, middle, final)

· If masturbation was successful but ejaculate was not obtained, it is necessary to immediately urinate and submit all obtained urine for analysis

· In this case, the analysis is registered not as a "spermogram", but as a "general urinalysis" – with a note on the referral form "Indicate the presence or absence of spermatozoa in the urine"

· It is necessary to deliver the biomaterial to the laboratory no later than 30 minutes after its collection

· During transportation, keep the sperm at a temperature of +27°C to +37°C

· The container with biomaterial must be delivered to the laboratory from 08:00 to 15:00, Monday through Friday; on Saturday the analysis is not performed.

Microscopic Examination of Urethral Discharge, Prostatic Secretion

· It is recommended to submit before the start of treatment

· If treatment has been started, discontinue the use of any medications, especially antibiotics, if possible, 2-3 days before the analysis

· Sexual abstinence is recommended for 2-4 days before the examination.

Rhinocytogram

· It is recommended to submit before the start of treatment

· If treatment has been started, discontinue the use of antibiotics and corticosteroid drugs, if possible, 2-3 days before the analysis.

REMINDER FOR THE PATIENT FOR COLLECTION OF BIOMATERIALS FOR BACTERIOLOGICAL EXAMINATION

Urine

General requirements for urine collection

· It is preferable to use the morning portion of urine; if this is not possible, urine collection for analysis should be carried out no earlier than 4 hours after the last urination

· Urine must be collected in an empty sterile container with a tightly screw cap

Stages of urine collection

· Before collecting urine, prepare a vessel with warm soap solution (use regular toilet soap), a vessel with warm boiled water, and a sterile container for urine collection (open the container lid slightly so that it can be removed with one hand)

· Wash hands with soap

· Before collecting urine, the patient must thoroughly wash the perineal area and external genitalia with warm boiled water and soap, and dry with a clean napkin

· Remove the lid from the container and take it in your hand, trying not to touch the edges

· Collect 5-10 ml of the middle portion of urine depending on gender

· Carefully close the container with the lid.

Preparation for urine collection (women)

· To avoid vaginal discharge getting into the urine, during urine collection it is recommended for sexually active women to insert a tampon into the vagina

· While holding the labia apart, release a small amount of urine into the toilet, pause urination, and then, placing the container under the urine stream, fill it

· Try not to touch the container to the body.

Preparation for urine collection (men)

· Retract the foreskin (if not circumcised), wash the glans penis with soap and warm boiled water, dry with a clean napkin

· While holding the foreskin in the retracted position, direct the urine stream into the container and fill it, while trying not to touch the edges of the container.

Requirements for the storage and carriage of urine

· Store no more than 1-2 hours at room temperature (20-25°C)

· Store no more than 12 hours in the refrigerator at 2-8°C.

Sputum

Rules for sputum collection for microflora inoculation

· Morning sputum released during a coughing fit is subject to testing

· Before coughing up, it is necessary to brush teeth and rinse the mouth with boiled water for the purpose of mechanical removal of food residues, desquamated epithelium, and oral microflora

· Ensure that saliva and nasopharyngeal mucus do not get into the container (especially during a runny nose)

· Collect the released sputum in a sterile, wide-necked container (diameter 35 mm)

· Close the lid tightly so that the material does not leak out

· If sputum is poorly separated, the day before you can take expectorants, or do a 15-minute inhalation with a solution of salt and soda

· Storage conditions: at room temperature for 2 hours, in the refrigerator (2-8°C) for up to 24 hours

· The volume of collected sputum should be at least 3-5 ml.

Breast milk

Rules for collecting breast milk

· Before expressing milk, thoroughly wash hands and mammary glands with soap, treat the nipples and areola area with cotton swabs moistened with 70% alcohol (each gland is treated with a separate swab)

· Express the first 5-10 ml into a separate container (this portion of milk is not suitable for testing), express the subsequent 4-5 ml into a sterile container with a red lid, trying not to touch the edges of the container with the body

· Milk from each gland should be collected in a separate container

· After expressing, tightly close the lid, trying not to touch the edges of the container with hands

· Label each container, indicating the surname, initials, date of birth, and on each container it is necessary to indicate: "right mammary gland" or "left mammary gland"

· The material must be delivered to the laboratory no later than 2 hours from the time of collection

· Milk before being sent to the laboratory should be stored in the refrigerator for no more than 24 hours.

Stool Examination

Rules for collecting stool for testing of stool for pathogenic and conditionally pathogenic microflora:

· A sterile container with a lid and a spoon should be given to the patient for stool collection

· Stool for testing should be collected in the morning.

Requirements for stool collection from the patient:

· Thorough hygiene of the external genitalia and anal area with soap solution followed by rinsing with boiled water

· Urinate beforehand

· Defecate into a dry, clean container – a bedpan

· Take the material for testing from the last portion of feces from the bedpan (pot) using the special spoon mounted in the lid of the sterile container, in a volume of no more than 1-3 g of feces (from the size of a pea to a bean) and tightly close the lid.

What should not be allowed:

· Stool testing should not be performed earlier than 2 days after an enema, X-ray examination of the stomach and intestines, or colonoscopy

· Do not take medications the day before, including:

· Laxatives

· Activated charcoal

· Iron, copper, bismuth preparations

· Do not use fat-based rectal suppositories

· Do not allow urine or water to enter the sample

Rules for collecting feces for the examination of intestinal microflora on dysbacteriosis:

· All examined patients, 1-3 days before taking the sample, should be on a diet that excludes the intake of foods that enhance fermentation processes in the intestine and fermented milk products, as well as alcohol, antibiotics, and bacterial preparations (containing bifidobacteria, lactobacilli, and E. coli)

· 3-4 days before conducting the stool test for intestinal dysbiosis, it is necessary to discontinue antibiotics containing intestinal flora (eubiotics), unless otherwise prescribed by the physician

· It is standard practice to conduct the test before the start of antibiotic therapy

· If discontinuation of the drug is not permissible, it is recommended to collect stool no earlier than 12 hours after the last dose of the antibiotic

· 2-3 days before, it is necessary to discontinue laxatives and rectal suppositories, unless otherwise prescribed by the physician

· Stool after the use of an enema is not suitable for testing

· The patient is recommended to urinate in the toilet

· The material is stool after natural defecation, which must be collected in a sterile disposable container with a screw cap and a spoon

· It is not recommended to collect stool from the toilet

· Collect stool on a clean surface, for which a clean new sheet (bag) made of polyethylene or paper can be used (this method is preferred)

· When using a bedpan, it should be thoroughly washed with soap and a sponge, rinsed repeatedly with tap water, and then doused with boiling water and cooled

· The material for testing is taken from the last portion of feces from the bedpan (pot) using the special spoon mounted in the lid of the sterile container, in a volume of no more than 1-3 g of feces (from the size of a pea to a bean) and tightly close the lid

· Delivery time to the bacteriological laboratory should not exceed 2 hours

· Storage and freezing of the sample are not permitted

· Optimal transportation temperature is 2-4-8°C

· Freezing and collecting stool for analysis "in the evening" is not allowed: "morning" stool should be tested, which must be delivered within 2 hours after defecation; the most informative is the last portion of stool, which is closer in consistency to a semi-liquid state.

REQUIREMENTS FOR DELIVERY OF BIOMATERIAL TO (FROM) THE CLINICAL DIAGNOSTIC LABORATORY

Biomaterial acceptance criteria

A properly filled in application for examination in the order form, with the following information:

· About the patient - full name, gender, date of birth, type of test, date and time of sample collection

· About the person responsible for monitoring the movement of materials, for receiving and transmitting information on services provided

· Contact information of the Customer

· Presence and full compliance of the patient's identification data in the application and in the biomaterial labeling

· Compliance of the laboratory container/vacuum tube for biomaterial with the type of test prescribed

· Absence of clots, hemolysis, or chylous serum in the sample

· Appropriate volume of material sufficient for conducting tests.

Criteria for refusal of biomaterial

· Unlabeled or incorrectly labeled samples

· Biomaterial from another patient

· Pronounced hemolysis

· Clot in the tube

· Violations (inaccuracies) in the completion of the referral for testing

· Leaking containers

· Contaminated samples

· Incorrectly collected biomaterial

· Broken glass slide with the sample

· Insufficient amount of biomaterial

· Delay in transportation and processing of samples

· Violation of the temperature regime during sample delivery.

Conditions for biomaterial delivery

· Tubes (containers with samples) must be labeled and packed in a thermal container in compliance with the required temperature regime

· The thermal container must be tightly closed.

·

Requirements for containers for biomaterial delivery

· Transportation of biomaterial is carried out in containers without refrigerant elements, except for certain blood samples (vacutainers with samples for testing ACTH, cortisol, aldosterone, homocysteine, calcitonin, osteocalcin, insulin, C-peptide should be placed on ice immediately after blood collection (to stabilize the analyte)

Containers for biomaterial delivery (hereinafter referred to as - containers) must meet the following characteristics:

· Ensure sanitary and epidemiological safety, eliminating the risks of infection during the transportation stage

· Containers for material transportation must ensure tightness, safety, and integrity of biological materials during transportation, protect samples from external factors, and also exclude the formation of aerosol when opening

· The container must be made of chemically resistant material and withstand treatment with all approved detergents and disinfectants

· Each transportation container must have a label describing its purpose, the required temperature regime, and the "Biological Hazard" sign

· If it is necessary to maintain a temperature of 2°C - 8°C during transportation in the container, thermal containers are used, in which the required number of refrigerant elements must be placed.

LICENSE TO ENGAGE IN MEDICAL ACTIVITIES

· State license of RSE "Medical Center Hospital of the President's Affairs Administration of the Republic of Kazakhstan" to engage in medical activities dated 06.11.2019 No. 19021984

· Appendix to the State License of RSE "Medical Center Hospital of the President's Affairs Administration of the Republic of Kazakhstan" for the provision of outpatient care to the adult population (Consultative and Diagnostic Care).

· Laboratory diagnostics: general clinical, serological, cytological, bacteriological, biochemical, immunological studies)

FOR PATIENTS, FAMILY MEMBERS AND VISITORS:

HOW TO FILE A COMPLAINT, COMMENDATION, OR SUGGESTION

Dear patients and visitors!

You have the right to express your complaint, disagreement, or conflict regarding the treatment of patients in any of the following ways:

VERBALLY:

• To medical staff (doctors, nurses, head of department);

· To the Hospital Administration (Block F): Deputy Directors, Director;

· To the Patient Quality and Safety Management Service (Block F, 3rd floor, room 42): via the helpline at tel.: 70-79-69.

IN WRITING:

• Book of complaints and suggestions in each department;

· Through the mailbox for complaints, suggestions and incidents;

· Addressed to the Director or his Deputies through the Department for the Development of the State Language and Document Management (Block F, 1st floor).

IN ELECTRONIC FORM:

• To the Hospital website at: www.bmcudp.kz;

· To the Medical Center of the President's Affairs Administration of the Republic of Kazakhstan: www.mcudprk.kz;

· To the blog of the Minister of Health of the Republic of Kazakhstan;

· To the office of the International Joint Commission JCI (Joint Commission International) at the link: JCIQuality@jcrinc.com.

The Clinical Diagnostic Laboratory of RSE "Medical Center Hospital of the President's Affairs Administration of the Republic of Kazakhstan" on REU operates in the spirit of commitment to the principles of continuous improvement of laboratory diagnostics quality

· Ensuring a consistently high level of quality of laboratory diagnostics

· In pursuance of its own Policy of RSE "Medical Center Hospital of the President's Affairs Administration of the Republic of Kazakhstan" on REU

The Management of the Hospital of RSE "Medical Center Hospital of the President's Affairs Administration of the Republic of Kazakhstan" on REU assumes the following obligations:

· To follow the professional standards adopted in the Republic of Kazakhstan in the field of laboratory diagnostics and the best international practices

· To conduct laboratory tests using highly effective methods and the application of the best innovative technologies, ensure that the tests meet their intended purpose

· To comply with the requirements of the standard ST RK ISO 15189-2023 "Medical laboratories. Requirements for quality and competence"

· To continuously improve the laboratory services management system

· To continuously improve the quality of laboratory services

Contacts of the Clinical Diagnostic Laboratory:

Head of CDL: +7 (7172) 70 - 62 - 95;

Head of the Laboratory of Personalized Genomic Diagnostics +7 (7172) 70 - 81 - 34;

CDL Registry Office: +7 (7172) 70 - 80 - 61;

Registry of the Microbiological Research Service: +7 (7172) 70 - 79- 48;

Express Laboratory: +7 (7172) 70 - 63 - 30, 70 - 62 - 99.

Staff: