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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 printer
Nurse 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