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January 17, 2014Specimen Identification: Nursing Workflow

Specimen Collection

Order Placed

(i.e. urine, CSF, Plasma,

etc.)

Nurse Verifies order

Nurse checks complete task in Cerner to print

specimen labels

Nurse leaves patient room to retrieve

labels from printerNurse obtains

specimen

Specimens Labeled

Bedside

Specimens

Transported

(via tube, walk-

downs, transport

team)

Issues:

Multiple labels printed at once

Delayed print of labels

Lack of educated on transport of specimens

Lack of education on where to find specimen collection

requirements

Machines

Verify specimen collect and transport requirements prior to

printing labels an collection

Supplies gathered post label print

Old labels sit on printer...mistakenly picked up and used on

incorrect patient

Education materials needed: transport work-instruction,

work-instruction on labeling, tube types and test names

Patients chart

stickers used

as place

holder until

lab labels

retrieved.

Nurse verifies labels

to patients ID

For hard sticks/heel

sticks/or issues with

draws, specimen

collected then

labels printed &

specimens labeled

(Regulatory issue)

Supplies

gathered

post label

printing

Legend

=process deviation

Recommendations:

Revise current lab labels

Pilot Plan:

>Place printers in all patients rooms of chosen ICU

>Pilot for 3 months

>Evaluate labeling incidents for 3 months against

changes made to units

Nursing education: including work instruction for transport

and proper labeling techniques

Minimize process variations including the standardizations

amongst each unit

Evaluate sunquest to determine if we can add test names

rather than test code to labels

Improve process for printer maintenance