mjshepherd Posted July 22, 2011 Share Posted July 22, 2011 I am interested in how other facilities handle specimen labeleing errors. Do you allow corections to mislabeled or incompletely labeled specimens? If you do how do you document the errors? I have alway been very strict on labeling errors rejecting anything recollectable submitted with incorrect or missing information. However, several nurses, including the CNO, have stated that other facilities have allowed them to relabel specimens if they "certify" the corrected information. Thoughts anyone? Link to comment Share on other sites More sharing options...
Marilyn Plett Posted July 22, 2011 Share Posted July 22, 2011 Several years ago, I heard Kathleen Sazama (both a physician and a lawyer) speak about errors. I was particularly impressed by the assertion that an incorrectly labeled specimen was 40% more likely to have "wrong blood in tube". I think that a labeling error should always lead to a recollect. Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted July 22, 2011 Share Posted July 22, 2011 Agree 100% Marilyn - and if anyone's opinion should be heard on this subject, it is Kathleen's. Link to comment Share on other sites More sharing options...
Deny Morlino Posted July 22, 2011 Share Posted July 22, 2011 I am with you on this MJ. If the specimen can be recollected, we have them do so. If it cannot, we are EXTREMELY careful to assure the specimen is relabeled correctly. Link to comment Share on other sites More sharing options...
Liz Posted July 26, 2011 Share Posted July 26, 2011 Without any hesitation we DISCARD the specimen. we ask for another collect. If it is not possible we check if there is a sample drawn at a different time in an other secction (and properly labeled). Never allow them to take back the sample and never allow them to re-label it. Link to comment Share on other sites More sharing options...
adiescast Posted July 29, 2011 Share Posted July 29, 2011 We do not allow relabeling of tubes. It causes problems because the rest of the lab uses an affidavit form to document when they have allowed relabeling of their tubes. Link to comment Share on other sites More sharing options...
tbostock Posted July 31, 2011 Share Posted July 31, 2011 We do not allow them to correct any patient identifiers (name, DOB, medical record #, or BBID #). We do allow them to correct date, time, or their initials. Link to comment Share on other sites More sharing options...
Liz Posted August 1, 2011 Share Posted August 1, 2011 I agree that they can write write their initials (and be accountable) BUT not touch the patient's triple name and MR#. the "Date" I wouldn't allow, one chap (oh sorry 11 yo doctor in a white coat) had a sample in his pocket for a few days, when asked why he said I was waiting for her to require blood. What!!!!!!!!!!!!!!!!!!!!!!! Link to comment Share on other sites More sharing options...
tbostock Posted August 1, 2011 Share Posted August 1, 2011 An AABB inspector recommended this long ago, that date, time and initials are not considered "identifiers" and as such can be allowed for correction. Any identifiers should NOT be corrected. My personal opinion is that any error on a Blood Bank tube should result in a redraw, but this was our "compromise" with nursing...I am not usually a compromiser, but I lost the battle on this one. Link to comment Share on other sites More sharing options...
AMcCord Posted August 1, 2011 Share Posted August 1, 2011 Several years ago, I heard Kathleen Sazama (both a physician and a lawyer) speak about errors. I was particularly impressed by the assertion that an incorrectly labeled specimen was 40% more likely to have "wrong blood in tube". I think that a labeling error should always lead to a recollect. This is a quote I trot out every time I'm having a discussion with our lab manager about accepting outpatient blood bank samples that have the name spelled wrong. I don't always win, but I give it a good try. Link to comment Share on other sites More sharing options...
pluto Posted August 1, 2011 Share Posted August 1, 2011 We reject any discrepancies - no exceptions , no sob stories accepted - patient difficult to bleed etc etc reject 5-6% samples received every month Link to comment Share on other sites More sharing options...
mjshepherd Posted August 2, 2011 Author Share Posted August 2, 2011 Thank you all for your input, I will be showing this to my transfusion commitee. I still think any error in specimen labeling should be discarded. I will do my best, wish me luck. Link to comment Share on other sites More sharing options...
LCoronado Posted August 2, 2011 Share Posted August 2, 2011 No corrections to identifying information EVER! Corrections to date, time, and ID of the phlebotomist are OK. However, if anything is missing entirely, the specimen is discarded. The reasoning: the tube was obviously not labeled completely before leaving the bedside, end of story. And yes, at times some people get very upset about it. Link to comment Share on other sites More sharing options...
AMcCord Posted August 4, 2011 Share Posted August 4, 2011 Better somebody upset, than a patient injured or dead. Link to comment Share on other sites More sharing options...
LabCare Posted August 9, 2011 Share Posted August 9, 2011 The contributing factor to the death of a patient with chronic renal failure and on dialysis was a specimen that was incorrectly labeled (not labelled immediately at "machine" side) and the Blood Requisition form incorrectly completed (No previous transfusions ticked off)Conclusion: Zero tollerance. Do it right the first time.In cases where a second sample could not be obtained, my instruction was to crossmatch and issue group O Link to comment Share on other sites More sharing options...
DPruden Posted August 12, 2011 Share Posted August 12, 2011 I completely agree, we reject all specimens that have errors with any patient identifiers. I am attaching a great article that I trot out anytime I need to defend my position. It is a Transfusion article from 1997. [ATTACH]518[/ATTACH]JohnsHopkinsmislable article.pdf Link to comment Share on other sites More sharing options...
ANORRIS Posted August 15, 2011 Share Posted August 15, 2011 Our ER department sends a patient sample to the BB incase the MD adds on a T/S or a XM. The request comes after the sample has been brought to the BB. Therefore, the sample and the request are coming seperately, not at the same time. I read std 5.11.1 as they must come together. Can anyone clarify this or add to it?AABB Std 5.11.1 states:Requests for blood, components, tissue, and derivatives and records accompanying blood samples from the patient shall contain sufficient information to uniquely identify the patient, including two independent identifiers. The transfusion service shall accept only complete, accurate, and legible requests. Link to comment Share on other sites More sharing options...
Liz Posted August 15, 2011 Share Posted August 15, 2011 They should arrive together. But then again, there are centers who recieve the request on the computer. I look forward to replies. Link to comment Share on other sites More sharing options...
John C. Staley Posted August 15, 2011 Share Posted August 15, 2011 Gotta love semantics!!! I don't see any where that indicates that the sample must physically accompany the orders/requests just when they do they must match. I think a case could be made for the word accompanying meaning "in association with" in this particular case. Link to comment Share on other sites More sharing options...
ANORRIS Posted August 15, 2011 Share Posted August 15, 2011 Gotta love semantics!!! I don't see any where that indicates that the sample must physically accompany the orders/requests just when they do they must match. I think a case could be made for the word accompanying meaning "in association with" in this particular case. I emailed the dilema to AABB. I will post their reply when it arrives. Link to comment Share on other sites More sharing options...
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