Lab Test Procedure : LABORATORY SPECIMEN COLLECTION GENERAL GUIDELINES
Document Control Version 4
Purpose: Akron Children’s Hospital is committed to providing quality care and a safe environment for our patients and clients. The exact method of phlebotomy will depend on the patient age and size. All Phlebotomy procedures must be performed according to procedures to avoid injury and ensure quality results.
Scope/Responsibility: Applies to: Akron Children’s Hospital Enterprise. It is the responsibility of the designated employee to obtain laboratory specimens following the appropriate procedures and policies specified in this guideline.
- It is the responsibility of staff to use a developmental, age specific and culturally sensitive approach in providing nursing care, preparing patients for procedures, and providing specific patient/family education.
- It is the responsibility of staff to utilize pharmacologic and nonpharmacologic interventions in a developmentally appropriate way.
- Body substance precautions apply for all specimen collection and transport procedures. Wash hands before and after specimen collection.
- For specific procedures on Specimen Collection, go to the Lab Test Directory and follow one of the next two routes:
Refer to the age appropriate preparation policy for proper interaction with the patient and family.
Patient Identification – Refer to Hospital Policy on Patient Identification.
Collection supplies should never be placed in a patient’s bed or near food and beverages
Specimen Labeling – All specimens, whether blood, urine, CSF, stool, etc. should be labeled immediately AFTER collection, before leaving the patient room/bedside. All labels must include two unique patient identifiers as well as the collection date and specimen collector ID. If lab-generated collection labels are not used, then the specimens must be accompanied by an audit trail or requisition that contains the same two unique patient identifiers that are on the specimen label. All specimens for Blood Bank MUST be accompanied by a double-signed blood bank requisition. (See “Specimen Labeling/Request Form Completion” policy.)
Dispose of all sharps in a Sharps container.
Notify the appropriate staff member who will notify the Licensed Independent Practitioner of the inability to obtain the specimen within the ordered time frame. Transportation of Specimens – Refer to two policies named – Transportation of Specimens and Hospital Pneumatic Tube System.
Expiration Dates – Monitor all expiration dates of specimen collection products on a regular basis.
Effects on Results:
- On the right hand side click on either Blood or non-Blood Specimen Collection Procedures. Then select the specific procedure needed.
- Or Go to the test list and select the actual test being collected. Then click on the item titled Specimen Collection Procedures and click on that link. You will be taken to the specific instructions.
- If the specimen collection procedure requires ice during transport, be sure to put ice in a separate bag from the specimen avoiding compromise of the specimen label.
The specimen collection process is also a major source of preanalytical errors in the testing process. Preanalytical errors include:
• misidentification of the patient
• unlabeled or mislabeled specimens
• use of the wrong anticoagulant
• wrong anticoagulant to blood ratio due to overfilling or under-filling of the tubes
• hemolyzed, clotted or contaminated specimens
• improper transport of specimens to the lab for testing
Because of the potential impact on the patient and the test results, it is important that anyone drawing blood or collecting specimens follow the established procedures.
Ernst, Dennis J. “Pediatric Pointers.” Center for Phlebotomy Education, Inc. 2004-2008, edited for accuracy 1/08.
Ernst, Dennis J. and Catherine Ernst. “Mastering Pediatric Phlebotomy.” Center for Phlebotomy Education, Inc. Adapted from Phlebotomy for Nurses and Nursing Personnel. HealthStar Press, Inc. 2001, updated 1/08.
Kiechle, Frederick L. So You’re Going to Collect a Blood Specimen: An Introduction to Phlebotomy, 11th Edition. Northfield, IL: College of American Pathologists, 2005.
Akron Children’s Policies
Age Specific Approach and Preparation of Patient
Specimen Labeling/Request Form Completion
Pneumatic Tube System