Transcript Improving the Accuracy of Patient Identification

Patient Identification &
Specimen Collection
How Proper Patient Identification and Proper Specimen Collection
Affects the Accuracy of Your Patient’s Laboratory Results
Lake Regional Health System
Who Says We Have To Do This?
The Joint Commission does……
NSPG.01.01.01 – Use at least two patient identifiers when
providing laboratory services.
 EP1: Use at least two patient identifiers when
administering blood or blood components, when collecting
blood samples and other specimens for clinical testing; and
when providing other treatments or procedures. The
patient’s room or physical location is not used as an
identifier.
 EP2: Label containers used for blood and other specimens
in the presence of the patient.
NO Room For Error……. Ø Tolerance
A LRHS Laboratory Services Manual for Nursing
Services is available on each nursing unit and on
the FISH under the lab tab. It is a complete and
detailed book of instructions covering:
• The ordering of tests
• Specimen collection requirements
• Patient preparation procedures
• Expected test turnaround time
• Any special specimen handling procedures to
insure integrity of a specimen
Accuracy of Patient Identification
To insure that laboratory tests are performed on the Correct Patients use at
least two (2) Patient Identifiers.
Inpatients, ER, SDS and OP’s receiving treatment in a bed:

Specimens shall not be obtained without a correct and complete armband.
The armband shall be replaced or corrected prior to obtaining any specimen.
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Check the Patient’s armband against the laboratory requisition/label. The
patient’s name and Hospital # must match exactly:
Outpatients

Ask the patient to repeat and/or spell his/her name and date of birth. Verify this
information is the same as printed on the order/label (young children or others
unable to give their name/DOB may be identified by their parent or guardian).
If there is any discrepancy do not obtain the specimen
until the discrepancy is resolved.
The Collection Process
1. The specimen shall be collected only by
personnel who have been thoroughly
trained in proper procedures and
instructed in the proper techniques.
2. Appropriate protective equipment shall be
worn for the specimen collection
procedure.
3. The accuracy of the lab result is only as
good as the quality of the specimen!
Enter the patient’s room with the
following supplies:
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PPE
Blood Collection supplies or Container
Label
Requisition (if available; i.e. for Urines)
Two (2) Biohazard Bags
The Labeling Process
Once the correct specimen is collected on the correct Patient the
specimen shall be labeled by the collector in the presence of the
Patient. (Do Not label tubes/containers prior to collection)
The Labels on the primary specimen container must include the
following information:
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Patient’s full name
Hospital number (for Inpatients)
Hospital number or date of birth (for Outpatients)
Date and time specimen was obtained
Initials of collector
Source of specimen, when appropriate
Did you know….these factors can
affect the accuracy of lab results
 Order of Draw is important when
collecting blood samples. Use
this order…
– Blood cultures
– Blue tubes (must be filled to
line)
– Red/SST tubes
– Green tubes
– Lavender tubes
– Grey tubes

Mix all tubes gently after filling!

Information on Lab tests and drug
screen interferences available on
the FISH…check out the LAB Tab!

Drawing blood above an IV site will
dilute/contaminate the specimen.

Turn off infusion for at least 1
minute and waste 5-10 mls when
drawing from a line to prevent
contamination/dilution of the
specimen.

Leaving the tourniquet on longer than 1
minute can increase the potassium.

A clot in a specimen will decrease
the platelet count and increase the
protime.

Hemolysis will increase the potassium,
AST, and ALT. It can be caused by:
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Exposure to heat
Excessive mixing/shaking
Pulling hard on syringe plunger or forcing
blood into tubes.
Poor needle placement in vein
Transporting the Specimen
When transporting the correct specimen on the correct Patient with the
correct labeling keep in mind:
 Securely close specimen tubes or containers to prevent leakage during
transport.
 Place specimen in a plastic Biohazard Bag for transport or delivery with the
requisition in the outside pocket.
 Care is to be taken to not contaminate the outside of the container or bag. If
the biohazard bag becomes contaminated, place into a secondary biohazard
bag prior to delivery to the laboratory with the requisition in the outside pocket.
 Specimens sent in the pneumatic tube system must be double bagged in
two plastic Biohazard Bags with the requisition in the outside pocket. Blood
cultures can only be sent through the tube system if placed in special leak
proof carriers.
 All specimens shall be delivered to the laboratory within the specified delivery
time in order to insure specimen integrity for the particular analysis to be
performed.
Last, but not least!!
You must always use the highest standards of practice:
 Wash your hands upon entering a patient’s room.
 Explain to the patient what you are doing and who you are.
 Provide privacy for the patient during the process.
 Obtain the specimen using your PPE.
 Remove PPE and wash your hands before leaving the patient’s room.
 Put the room back in order when you’re done (i.e., call light in place)
 Make the patient comfortable.
 As the patient if they need anything or if you can do anything for them.
Summary
 All specimens sent to the LRHS
Department of Pathology
(Laboratory) shall be properly
Collected, Labeled and
Delivered.
 Reference: Laboratory Services Manual for Nursing Services,
Department of Pathology and Clinical Laboratories
Lake Regional Health System, Osage Beach, MO
The End!
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