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Managing Preanalytical Processes for Patient Safety

up manager for phlebotomy and specimen processing for ARUP Laboratories at University of Utah Hospitals and Clinics, Salt Lake City, finds that communicating and reinforcing hospital policies and procedures on specimen collection was not enough to reduce rejection rates for nurse phlebotomy.

"You have to explain to nurses the reasons behind the procedures. Nurses and laboratory personnel have different mindsets and incorrect assumptions about each other, Wright says. "Lab staff incorrectly assumes that all nurses understand the reasons underlying the order of draw and specimen rejections. There is a better compliance with specimen collection policies and procedures when nurses and other specimen collectors understand why you need to do things a certain way."

A consistent method of collection that everyone adheres to eliminates shortcuts that have been instilled into the staff culture for years.

An Example of an Effective Solution:

Several products on the market can be used for patient ID. One such product is the BD id Patient Identification System, by Becton, Dickinson and Company (BD), Franklin Lakes, NJ, which requires that the phlebotomist scan her ID badge and scan the patient's armband. The device indicates the collection details, such as the number and types of tubes, and order of draws. The phlebotomist completes the process by scanning the tubes, printing the labels and applying them to the tubes while still at the bedside. The system can be wired or wireless and effectively communicates between the handheld device and the server. The server is updated frequently, allowing the lab and nursing floor to track the location and status of the specimen.

Why is this important? First, more efficient collections result in fewer venipunctures for patients. The technology confirms at the bedside that the right tube is collected for the tests ordered and eliminates the need for a lab-applied third label. According t
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