Standards Update: Sample labeling

The newly revised venipuncture standard released by the Clinical and Laboratory Standards Institute in April, 2017 is the most comprehensive revision in the document's history. With over 140 new mandates, facilities have a lot of changes to implement. This series discusses one or more substantive changes each month.

You pride yourself in strictly adhering to the standards and your facility's policy on patient identification. You realize a mistake in this first step of a blood draw can kill a patient, so you make no exceptions. Not ever. You've seen how devastating it was for others throughout your career, and you have vowed never to let that happen to you, or any patient you draw. You have never misidentified a patient, and you probably never will.

But patient identification errors are not the only type of deadly ID error those who draw blood samples commit. Tube-identification errors can be just as deadly. 

According to the latest version of the CLSI venipuncture standard, released one year ago this month, those who draw and label blood samples must compare the labeled tube to the patient's ID band before leaving the patient. If your patient is an outpatient in a facility that does not routinely put ID bands on outpatients, the standard requires you to show the labeled tube to the patient and seek confirmation that the information on the tube is accurate. If the outpatient is not capable of confirming the label on the tube (e.g., if the patient is sedated or otherwise cognitively impaired, has a language barrier, is an infant, etc.), the collector must have a caregiver, friend or family member confirm the information on the patient's behalf.

In many facilities, phlebotomists leave the laboratory with preprinted labels for a multitude of patients, especially for morning draws. Meticulously assuring the patient is the right patient does not guarantee the label they put on the tube is the right label, though. By comparing the tube with the ID band or securing patient confirmation, potentially deadly ID errors are prevented on the front and back end of the procedure. 

Editor's note: Readers are urged to obtain their own copy of the standard as soon as possible and begin implementing all new provisions immediately. The document, Collection of Diagnostic Venous Blood Specimens (GP41-A7), is the standard to which all facilities will be held if a patient is injured during the procedure or suffers from the consequences of an improperly performed venipuncture. It can be obtained from CLSI or the Center for Phlebotomy Education, Inc.