Patient Identification

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Patient Identification Specimen
CollectionHow Proper Patient Identification and
Proper Specimen Collection Affects the
Accuracy of Your Patients Laboratory Results

• Lake Regional Health System

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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 patients 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.

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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

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• 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 OPs 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.
• Check the Patients armband against the
  laboratory requisition/label. The patients 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.

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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!

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Enter the patients room with the following
supplies

• PPE
• Blood Collection supplies or Container
• Label
• Requisition (if available i.e. for Urines)
• Two (2) Biohazard Bags

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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
• Patients 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

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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 FISHcheck 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
• Exposure to heat
• Excessive mixing/shaking
• Pulling hard on syringe plunger or forcing blood
  into tubes.
• Poor needle placement in vein

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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.

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Last, but not least!!

• You must always use the highest standards of
  practice
• Wash your hands upon entering a patients 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
  patients room.
• Put the room back in order when youre 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.

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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

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