In response to the request to post the new phase II CAP requirement on cross
contamination :
**NEW** 08/21/2017
ANP.11680 Cross Contamination Phase II
There is a written procedure to prevent cross-contamination of specimens during
grossing.
NOTE: At a minimum, cleaning (e.g. wiping or rinsing) of forceps and scalpel
blades between cases is required. In addition, if a laboratory processes both
small specimens (e.g. biopsies) and large specimens (e.g. surgical resections),
cleaning of instruments and cutting surfaces must be performed between cases.
Avoid re-using cotton swabs/applicator sticks on multiple specimens or
"double-dipping" the cotton swab/applicator in the ink. Some laboratories may
choose to use disposable surfaces (e.g. formalin absorbent pads, butcher paper,
etc.) for large cases. Grossing of similar types of specimens sequentially
should be avoided, if feasible.
REFERENCES
1) Lott R, et al. Practical Guide to Specimen Handling in Surgical
Pathology. College of American Pathologists, November 2015. Available at
http://www.cap.org/ShowProperty?nodePath=/UCMCon/Contribution%20Folders/WebContent/pdf/practical-guide-specimen-handling.pdf,
Accessed November 4, 2016.
2) Gephardt GN, Zarbo RJ. Extraneous tissue in surgical pathology: A
College of American Pathologists study of 275 laboratories. Arch Pathol Lab
Med. 1996;120:1009-14
Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal
2. Re: Cross Contamination CAP policy (Bob Richmond)
Message: 2
Date: Sat, 13 Jan 2018 14:32:45 -0500
From: Bob Richmond <rsrichm...@gmail.com>
To: "Histonet@lists.utsouthwestern.edu"
<histonet@lists.utsouthwestern.edu>
Subject: Re: [Histonet] Cross Contamination CAP policy
Message-ID:
<caoksrh50bp+fbdnf3fnj_rgenc9tht1wa6wkbbaae3kae41...@mail.gmail.com>
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Terri L. Braud, HT(ASCP), Anatomic Pathology Supervisor at Holy Redeemer
Hospital in Meadowbrook PA notes:
>>Our policy calls for wiping of forceps with gauze between cases at
>>gross
and at embedding. At gross, we use a disposable absorbent lined pad on the
cutting board for each larger case, and just a fresh c-fold paper towel between
small biopsy cases. We do not allow double-dipping of swabs into ink, but
instead, pour out small amounts into a large plastic weigh boat which is also
discarded after the case. We use disposable safety scalpels, with a 70 blade
(love 'em) for each case. For excessively bloody/fatty cases, we put the dirty
forceps into an enzyme pre-soak (Aseptizyme) to remove all tissue debris. Then
they are scrubbed with a brush, then rinsed in a disinfectant before being
re-used.<<
I've never seen a pathology service (and I've worked in 80 of them) do any of
these things, all of them good ideas. I'm glad to see the CAP taking the issue
up. Carry-overs from case to case are common, particularly when the grosser is
overworked and working too fast. I've never seen a serious error made as a
result of such contamination, but I've seen a few close calls.
Terri Braud, could you copy us the actual text in the CAP inspection form?
Bob Richmond
Samurai Pathologist
Maryville TN
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