Blood sample labelling requirements?

[Liann]

I work in a hospital transfusion service and we are revising the sample labelling policy. We currently require : Pt full name, ID#,date and the initials of the person drawing the sample. A significant number of samples arrive lacking at least one of these identifiers. We have allowed the staff member who drew the tube to come to the Blood Bank to fix the label, but our medical director wants to change the policy and require a new sample to be drawn if the first is lacking ANY of the 4 requirements.

What is the policy at other facilities? I expect much wailing and gnashing of teeth if I throw away a sample from the ER or NICU for labelling deficiencies....

[rreed]

we have to have:

Pt name

Med Rec Number

Date and time

Person's Id that drew it (we were making 2 people sign the sheet and blood braclet saying it was done right before sending it to the lab)

and if you miss one thing on it after sending to the lab, it is trashed and you redo it no questions ask.

[neneRN, BSN, RN]

Our blood bank is very strict- you forget any of the identification requirements and you need to redraw-NO EXCEPTIONS. It works-I've only made a mistake once when I was first hired and I haven't made another. Staff knows their policy and because of this constant, rarely forget to label properly. I don't mind this, it protects you too.

[gwenith, BSN, RN]

I can definetly understand this policy of redraw for blood transfusions and theblood bank here is VERY strict - tehy are less srict about electrolytes etc.

[rreed]

with electorlytes, if there is a big change from the last draw, they will reject the first draw and ask you to redraw it

and if you forget to put the time and your id number on it then it is a redraw on any blood sample where I work.

[MtnMan]

This is an area where there is no room for error. However if all the info is on at least one of the samples required for crossmatch a little leniency could be afforded because it is the patient that is ultimately inconvenienced. I was trained by USNavy name, dob, room or id# date time and collector plus a blood bank #. I am amazed frequently by my co-workers that fail to properly label specimens. Lab specimens are as important as meds.

[Liann]

NO exceptions? ever?

We have a lot of agency and casual nurses, and EMTs who work at our hospital. I anticipate a long and steep learning curve to occur. I work a lot of weekends and do not have the luxury of backup from my supervisor or medical director at that time. I guess I am expecting some resident or ER nurse to shreik that I am killing their patient by demanding a new sample.

[KaroSnowQueen, RN]

When we get blood draws, a label prints out for us with the pt name and number, room number, and the test being drawn. We then sign it with our initials and time. (It's already dated, too.)

Drawing for blood transfusions also requires blood bank bracelet to be put on pt and that # must be on tube also.

The only ones that get trashed if not right are the blood tranfusion samples, if not right, they get thrown right out. The others are called to the floor and we go down and fix them. Your proposed policy seems a bit harsh. Nurses have to draw their own blood at my facility and to redraw seems a bit much for a tube that is missing a time or initial. Seems if it has the pt name and # on it that is the most important thing.

[NicuGal, MSN, RN]

Patient name, MR number, encounter number, date, time and your signature on the label and req. If it is missing one thing, it is pitched, no if-and-or-buts about it. After it happening to you on a micropreemie, you will never forget again!

[Liann]

We do not use blood bank bracelets, but from what I hear from others, it seems to be a good idea. I imagine that we will have to use them in the future, but its not being considered at this time.

[Zee_RN, BSN, RN]

We get the label from the lab that has the patient's name, MR#, etc. We initial, time & date that label...for the ones that we draw. I work at one of the few facilities where nurses do NOT phlebotomize; our lab employs phlebotomists who round the hospital for all blood work. The only blood work I draw is if the pt. has a central line.

[Liann]

Part of the problem IS our phlebotomy team. We are so short staffed that the draw runs take longer and longer each day, and on weekends (due to call- offs) theres sometimes only one person to draw the entire flippin hospital. Morning draw list has at least 140 patients to stick. Thats a whole other thread!!!

Therefore, nursing must draw samples more and more often in order to get tests done in a timely manner. No one has time to look up labelling requirements and we field calls all the time as to what color of tube do we need and what goes on the label.

Proper patient ID is so critical, and the accountability issue is finally getting addressed by this policy of correct labelling. I hope that all involved will see this change as a good thing. I have my doubts, though.