Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

10 Things Every Nurse Should Know About The Lab


Published on

These are the top 10 things nurses should know about the lab in order to increase the safety and efficiency of the care they provide.
Original blog post:
Follow me on Twitter: @meredithhurston

Published in: Health & Medicine, Business
  • Be the first to comment

  • Be the first to like this

10 Things Every Nurse Should Know About The Lab

  1. 1. e m po we re dm o chapat ie nt .co m http://www.empo weredmo m/blo g/2013/12/14/to p-10-things-every-nurse-kno w-lab/ on Top 10 Things Every Nurse Should Know About The Lab Hu rst Author: Meredith Hurston ere dit h Nurses are awesome! They survived nursing school (no small f eat) and really just want to go to work everyday and take care of their patients in an ef f icient manner. I totally understand. I’m here to f acilitate that with my top 10, served up with a little satire and sarcasm f or f un. I want us, the collective healthcare team, to start extrapolating our daily cause a little f urther and think to ourselves, I just want to go to work and take care of my patient, SAFELY and ef f iciently. Here goes everything: 1. We Don’t Clot Your Purple Tops to fM As hard as it is to believe, there honestly is not a clotting gremlin traipsing around the lab, itching to wave his double double, toil & trouble wand over your purple top. Purple tops start to clot at the time of collection, if the specimen is not properly collected and mixed. lab gremlin gh 2. Stick Your Patient WHENEVER Possible tex tc op yri The pref erred method of specimen collection is to perf orm a venipuncture. As crude, insensitive, lacking compassion and counterintuitive as it may seem, the best quality blood specimens come f rom a routine venipuncture. I get it. There are circumstances where patients have “bad veins,” have a line, don’t want to be stuck, or they are on bleeding precautions and can’t be stuck. However, it has been my observation on numerous occasions where a venipuncture should be the f irst choice, the nurse just chooses to pull it of f the I.V. Venipuncture 3. Hemolyzed Specimens Are Problematic. Typically a hemolyzed specimen is the result of poor/slow blood f low into the tube during collection. It also can happen when blood is f irst collected in a syringe and then transf erred to the tubes. It must be transf erred to the tube immediately. If allowed to sit on the counter or in your pocket while you go get tubes, the blood starts to clot. Then when you go to transf er it, it’s more dif f icult to push and it hemolyzes the specimen.
  2. 2. 4. The I.V. Start on This is my f avorite. Somewhere along the way, I think it has been engrained in nurses everywhere that the best time to collect blood is when you start an I.V. If I could only accomplish 5 things in lif e, I want 1 to be to change this culture. Peripheral I.V. insertion and phlebotomy are 2 separate procedures. I know, “it’s more ef f icient” to draw the blood when starting the I.V. However, you may jeopardize the line by trying to manipulate it to get blood. AND, it of ten requires the use of a syringe, see #3 f or why this isn’t good. Hu rst 5. The 23G Butterfly Needles With A Syringe The Perfected Side-eye ere dit h Should be used f or special circumstances and pediatric patients, not f or EVERY patient. Why? They are expensive. And a properly skilled phlebotomist should know how to routinely use a straight 21G or 22G needle with a vacutainer hub adapter. to fM 6. Labels tc op yri gh This may quite possibly be the bane of any laboratorians existence. It is critical that specimens be labeled correctly with 2 patient identif iers, pref erably f ull name & medical record number. This should be done: 1) at the bedside, 2) at the point of collection and 3) af ter you have properly identif ied the patient by reading/barcode scanning their wristband and/or asking their f ull name and date of birth. This means it is BAD to stick the tubes in your pocket & go to the nurses station to label them. It’s a huge opportunity f or a mix up to happen. tex 7. Results Don’t Match? Nurses loathe when the lab calls to say they need a new specimen because the previous results don’t match or appear to be discrepant. How does this happen? The lab has a handy dandy f unction in the computer system called a delta check. Af ter the analyzing instrument sends the result to the computer, the computer looks back at the patient’s previous results f or that particular test. If the results dif f er too much f rom the predef ined limit, most likely a new specimen will be requested to conf irm the change. In most cases the provider is consulted to be sure it isn’t an expected change based on the clinical picture.
  3. 3. 8. Read And Read Back Of Critical Action Values/Panic Results It’s annoying, time consuming and you don’t like it. I already know, BUT, it’s important f or patient saf ety. That’s why we do it. ere dit h Hu rst on 9. The Blood Bank I have f ond memories of working in the blood bank. It was one of my f avorite departments to work. I digress. This is the most anal retentive area of the lab and justif iably so. Blood bankers want every patient to get the right blood product every time, without f ail, EVER. So there are extra precautions in place to mitigate that. We need to know who drew it, when it was collected. It must be properly labeled with the patient’s f ull name, medical record number, date of birth and transf usion history, if it is known. When blood is being issued, we take our time to go over the patient’s name, medical record number, date of birth, blood type, unit type, unit number. This verif ication step is necessary at issue and bef ore administration, to catch any mistakes. PLEASE be just as diligent as we are when you administer the blood to the patient. Verif y the inf ormation with another team member. 10. Specimen Cups Urine, stool, body f luids, etc. go down to the lab in specimen cups. The mention of those things probably made your lips curl just a bit. PLEASE make sure you screw the lid on tight. And label it. That’s all! op yri gh to fM I love healthcare! It’s in my blood and it’s what I know. For over 20 years, I have lived healthcare, either navigating it with my Mom or being a patient myself , and as a healthcare prof essional. One thing I know f or sure is that our system is broken. Besides the rare individual that slips through the cracks, no healthcare worker wakes up with the intention to do harm to a patient at work. Consider these 10 things as you That’s All move about your day. Now you know the why behind some of the things that make your blood boil when you think about the lab. Is the lab perf ect, heck no! But let’s all work together to take care of the patient, SAFELY. tex tc Now tell the truth, which one are you guilty of? About The Author: Meredith Hurston I am the Founder and Editor of The Empowered Mocha Patient. During the day, I’m a quality assurance and patient saf ety data coordinator. I spend the rest of my time pursuing my passions, which are, mentoring young ladies and sharing what I know about healthcare. I’m a writer, cof f ee drinker, golf er, always ready to learn something new and actively trying to build my brand. Follow me on Twitter @EmpowerMochaPt and on Facebook.