Blood sample labelling requirements?

nimbex, RN · Apr 10, 2003

we have 2 labels we have to use to ensure the "chain of identification" isn't broken. Every patient has an identiprint band on their wrist band, you take this label maker, side the band tag in it and a yellow sticker comes out. this yellow sticker has the pt. name, mr# on it. No yellow sticker.... no running the sample period.... can't leave the room without it being on the sample.... that way there is ZERO chance of mislabeling. then we take a barcode label that has the same info, plus the test being run and put it on the tube too.

then, date time and initials.

Liann · Apr 10, 2003

OOH..thats cool. Who makes that nifty gadget?? I have not heard of it before. Probably expensive....and my organization is notoriously stingy...but cool, nevertheless... :)

nimbex, RN · Apr 10, 2003

uummm, not sure, working friday, will find out and pm ya. I really don't think it's expensive.... just some plastic, gun thing and a roll of stickers.....and the band is just a hard plastic rectangle that fits in their hospital band.

trust me, we find the cheapest solution too., but at least they try. I'll let ya know

deespoohbear · Apr 10, 2003

Originally posted by 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.

How on earth does the nurse check the pt's ID and transfusion info without a blood bank bracelet? At our facility the person who draws the pt for the T&C has to band the pt, no exceptions. A couple of the lab people have forgot to "band" the patients and went off duty. They were promptly called to come back to the facility and "band" the patient.

I thought blood bank bracelets were mandatory for anyone who was T&C. I wouldn't think of transfusing a patient without a blood bank bracelet and the proper ID.

Liann · Apr 10, 2003

Of course the patient has a regular hospital bracelet with name and medical records number, etc which is matched to the name and MR # on the tag of the unit of blood. Patients blood type and the type of the unit are clearly marked on the tag.

I dont know exactly why we dont use blood bracelets, but I suspect it has to do with costs.

dabestrn · Apr 10, 2003

Liann, I am in AWW that you do not use blood bank bands! I am not sure but I would say there is some violation being occurred by some governing body such as JACHO. I work ER and worked in 4 different ER's. They have all been the same, you have to have name, MR, date/time and initial of person drawing. If any missing, then redraw is needed. No exceptions! This should be policy of every hospital. This shouldn't be hard. You just stamp a sticker with the name plate, which should have name, MR# and date already on it, then all you need to do is put the time and your initial on it. I did work in one hospital that had one of those gadgets that you could get labels from the pt's armband. If your ER has agency nurses, they should have worked in other hospital and they should be used to all this stuff coz almost all hospitals have these standards.

Liann · Apr 10, 2003

We just had an inspection in Dec by the JCAHO, and we are OK as far as they are concerned. We do require name, ID# , date and initials on the tube, but the issue is if we need a redraw or can the person who drew the tube fill in any missing info. Currently we allow staff who forget to initial, or if MR # is cut off the printed label, or if anything is illegible, etc to fix the tube.

The new policy WILL be to throw out the tube with an incomplete or illegible label and request a redraw. I am looking forward to having a solid policy, and support this 100 per cent. I dont think that other departments ie: ER and NICU for example, will readily comply, especially on evenings and weekends. We will see.

You are right, this is not hard to do, but a shocking amount of specimens arrive with info missing. (Our data suggests that the total is somewhere around 4 per cent of all BB specimens.) Even with a name plate to stamp a sticker, most of the time some part of the name or number is cut off. Then what? I guess we will have to throw it out.

I was curious as to what other hospitals do. It seems as if we are in line with all the others if we request a redraw. That makes me feel better about this new (at least to our blood bank) policy.

Thanks to all for your input.

RNforLongTime · Apr 12, 2003

Originally posted by 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....

I've forgotten to place the time the sample was drawn on the label. Problems arise when the person you are sending blood on is a HARD stick and has no central access.

Whenever I send blood, usually the lab tech leaves the labels at the bedside for me. If not then I use the hospital generated bar-code labels which has the pt name and ID on them then I just date, time and initial that label. If there is NO label then our lab makes us re-draw the specimen.

OrthoNutter · Apr 12, 2003

Originally posted by neneRN
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.

Same here....I'll never forget finally getting some blood off a lady who I'm sure only has one suitable vein left in her entire body and even then, it's like trying to get it out of the proverbial stone. After much swearing, cursing and even pleading to the blood bank to please let me label my initial (which was the only thing missing) at the lab, I bolstered up my courage and went back and told the lady I needed a redraw. Saturated with the contents of one water jug and twenty minutes later, I emerged with the redraw. I've never EVER forgotten to label something properly since. :chuckle

P_RN, ADN, RN · Apr 13, 2003

Definitely blood band. How else could it be done? Also our txm samples had to be HAND WRITTEN to avoid any chance of the wrong addressograph being used. Nothing left the room until everything was labeled and then it was taken to the tube system.

You couldn't do more than one patient so as to avoid mixing corvacs.

P

SmilingBluEyes · Apr 13, 2003

Originally posted by Liann
We just had an inspection in Dec by the JCAHO, and we are OK as far as they are concerned. We do require name, ID# , date and initials on the tube, but the issue is if we need a redraw or can the person who drew the tube fill in any missing info. Currently we allow staff who forget to initial, or if MR # is cut off the printed label, or if anything is illegible, etc to fix the tube.

The new policy WILL be to throw out the tube with an incomplete or illegible label and request a redraw. I am looking forward to having a solid policy, and support this 100 per cent. I dont think that other departments ie: ER and NICU for example, will readily comply, especially on evenings and weekends. We will see.

You are right, this is not hard to do, but a shocking amount of specimens arrive with info missing. (Our data suggests that the total is somewhere around 4 per cent of all BB specimens.) Even with a name plate to stamp a sticker, most of the time some part of the name or number is cut off. Then what? I guess we will have to throw it out.

I was curious as to what other hospitals do. It seems as if we are in line with all the others if we request a redraw. That makes me feel better about this new (at least to our blood bank) policy.

Thanks to all for your input.

this is pretty much how it's done where I work. The lab comes up and if anything is missing AND the nurse involved corrects and signs it, we are ok. I have learned not to forget for many reasons, but mostly not to get this wrong or inconvenience the patient are the biggies..

LaVorneRN · Apr 13, 2003

Working in a lab as a lab asst. and phlebotomist before getting into nursing, I realize there is a reason for everything. While you may not know the reason or agree with it, a whole lot goes on in other depts. you don't work in. As a phlebotomist I know the things needed on a tube of blood and if all elements are not there(like time) the blood may be too old to be used for other tests later, the blood may have been drawn on the wrong patient-but who drew it?(initials and pt. name/med.rec.#), values may be critical and need to be redrawn but was it drawn at the right time(hence timed lab draws) There are other elements I am not aware of as I am not a lab tech. If you know what is supposed to be done, just do it-no matter how busy you think you are. Respect the other depts. and their requirements. They have rules to follow and reasons for everything. Policies usually change and get stricter when there have been errors or situations prompting a constructive change. Patients wonder why their VS have to be checked q15min. after surgery, why they have to be fasting for a test, etc.-if you screw up a 24hr urine-guess what? You start over. We understand why we do what we have to do but others may not. That doesn't mean we skip a few VS post op and if we do is it okay? I agree big time that if you get it right the first time you save the patient, more than anything, further discomfort and problems (especially if you drew the wrong patient or the right one at the wrong time on top of mislabeling-it has happened).