1. At our hospital, the nurses draw the vast majority of the blood bank samples. Only very occasionally do we get one drawn by the phlebotomists. Blood bank tests can't be ordered by the floor, so no draw order gets sent to phlebotomy. All our samples have to have the 2 identifiers, date, and initials of the person drawing or the sample gets written up and thrown away and a new correctly labeled sample requested. Either the rest of the lab didn't have the same requirements as blood bank or they weren't as strictly enforced (I've always been fuzzy on the exact situation), but our new lab director has been very strict about the blood bank labeling policy applying lab-wide (and adding time of draw too). That has greatly reduced the number of mislabeled samples we get... 2. We don't use armbands... 3. We require a confirmatory sample on all patients with no prior history. We only perform a forward type on these samples and the patient isn't charged for the test. If they can't get a 2nd sample, we require that an emergency release be signed before we issue any blood products. Nursing grumbles about this from time to time, but oh well...we almost always get the sample and very rarely have to issue under an emergency release. 4. Although we do rarely get the wrong patient information on a sample, this has always been caught with the second sample. It of course gets written up and sent to nursing to deal with, I don't know how hard they come down on them in those situations though...