How To Reduce Specimen Labeling Errors

Labeling errors are also a concern in smaller research labs, where missing specimen information can lead to inefficiency, costing valuable time and sometimes requiring an experiment be redone. Labeling errors can lead to possible serious misinterpretation of test results when specimens with similar identifying information enter an environment where thousands of specimens are handled each day and results must be accurately associated with your patient among the many. Most mislabeling errors are detected when the specimen and. —Proper specimen identification and labeling is a critical preanalytic step in pretransfusion compatibility testing. Ensure that all samples contain at least 2 unique identifiers and the information on the sample matches the information on the requisition. Specimen-labeling concerns at the facility necessitated a quality improvement program to correct errors related to wrong-patient labels, typographical errors and specimen bottles sent to the pathology lab without labels, says Dawn Francis, MD, a Mayo gastroenterologist and the study's lead author. In May 2015 Brigham and Women's Hospital (BWH) implemented a vendor-based standalone specimen collection product, interfaced to the Electronic Health Record (EHR), to positively identify the right patient to the right specimen order. 4%) than by clinicians (22%). As a result, a quality improvement initiative was created to reduce the number of specimen-labeling errors. The project involved incorporating specimen. Patient identification. Radio-frequency Identification Reduces Specimen Labeling Errors Date: October 13, 2008 Source: Mayo Clinic Summary: With a long-held commitment to continuously improving the quality and safety of. The most frequently reported interventions to reduce specimen-labeling error are strict policies (in clinical setting and Blood Bank), education, and two person checks. org Stephen E. It's also a daily time-saver for phlebotomists and other staff tasked with collecting specimens, since up-to-date information about what to draw and in what order appears automatically on their device. JavaScript seems to be disabled in your browser. By utilizing wireless handheld and printer technology, MobiLab is. • Minimum label requirements: The label should contain date, time and initials of the staff member who collected the This information is vspecimen. Most labeling errors have been due to either the wrong patient label or no label being affi xed to a specimen bottle. All samples MUST be labeled with ALL of the following information: a. Capture additional information to improve. Preanalytic errors (those oc-curring before the sample or speci-men is analyzed) account for 60% to 75% of all lab errors. According to CLIA (Sec. Accurate labeling at the point of care can prevent many specimen identification errors and resulting problems. (See Reduce the likelihood of patient harm associated with the use of anticoagulant therapy. Initiatives implemented to reduce specimen ID errors included:. Further data from subset of four studies showed a significant decrease in specimen labeling errors after the institution of the standardized specimen labeling protocols (Median relative percent decrease in specimen labeling errors: −72. To ensure fast and accurate testing, KGH has been focused on reducing the number of specimen collection and labeling errors being made. 8 The Food and Drug Administration has proposed bar-. 1 While this is a cumulative statistic, errors made in patient and specimen identification, labeling, and handling certainly can lead to diagnosis or treatment errors, as well as erosion of trust from providers, patients, and their families and inappropriate. Phlebotomists also are required to confirm a. and colorectal surgery endoscopy units. Causes, consequences, detection, and prevention of identification errors in laboratory diagnostics. " This study used a technology, radio-frequency identification (RFID), to track biopsy specimens taken during gastrointestinal endoscopic procedures and to automate identification. Labeling away from the bedside was the second-leading cause. Phlebotomists can make any number of errors that compromise specimen integrity in ways that clinical laboratories cannot detect during the testing phase. Annals of Emergency Medicine. This allows the ED staff to properly collect virtually all specimens as part of their normal workflow. Errors can be caused by: Lack of patient identification and/or sample labeling Transcription errors due to manual data entry Lack of a procedure for identifying patient and samples Errors can lead to: Noncompliance Misdiagnosis Incorrect treatment of a patient Need for resampling Lost billing opportunities. 8 Automated detection of serum indices such as the hemolysis index is more reliable than visual observation. Despite an intense focus on proper specimen labeling and other strategies for reducing identification errors, these problems still occur. specimen labeling also has been shown to be successful, leading to a 75% reduction in lab-oratory specimen-labeling errors. Iatric MobiLab software brings positive patient identification, positive specimen identification and specimen label printing to the bedside. 1 While this is a cumulative statistic, errors made in patient and specimen identification, labeling, and handling certainly can lead to diagnosis or treatment errors, as well as erosion of trust from providers, patients, and their families and inappropriate. There is, however, a direct, effective way to drastically reduce specimen-label errors: barcode labeling of blood and other samples at the time they are collected, in the presence of the patient, using a networked PDA device or mobile PC and a mobile printer. For example, faulty specimen collection techniques can bump up potassium readings by 1-2 mEq/L. technology can markedly reduce misidentification and specimen mislabeling errors. 1553 x237 to find out how you can improve sample collection and identification. Specimen Labeling •Positive patient identification and strict adherence to policies and procedures is imperative throughout the process of collecting and labeling specimens to help assure patient safety. 7% were related to specimen errors, and 58. To address the applicability of the implementation of evaluated interventions to reduce specimen labeling errors, we also investigated whether the effectiveness of these practices varies according to the type of the setting or population (e. Surgical specimen errors were defined in all stages of the SPSM process, in the intraoperative phase during specimen ordering (8%), labeling (6%), containment (4%), transport or storage (40%), and collection. So is the value of bedside labeling. Background Accurate patient identification and specimen labeling at the time of collection are crucial steps in the prevention of medical errors, thereby improving patient safety. For the purposes of this project, the. Labeling Templates • Specimen Labels, Avery 5160 • Every specimen submitted must be labeled! 8 Large Specimen Labels (Tissue/Pathologic Specimens) Small Specimen Labels - Pharmacokinetics (PK) Small Specimen Labels (Fresh/Frozen Liquids) Hint: Cut here to reduce label size. Strategies to reduce the rate of these errors should be a research priority. A weak link between the requisition and patient specimen allows one to start with patient A’s requisition and draw a specimen from patient B, making “specimen-requisition mismatch” and “wrong-blood-in-tube” errors possible. To reduce such errors, the following series of strategies were implemented: a restrictive specimen acceptance policy for the ED and IPD in 2006; a computer-assisted barcode positive patient identification system for the ED and IPD in 2007 and 2010, and automated sample labeling combined with electronic identification systems introduced to the. For example, faulty specimen collection techniques can bump up potassium readings by 1-2 mEq/L. Benefiting From Bedside Specimen Labeling Labeling blood and other samples at the time they are collected improves patient safety and helps prevent a host of problems related to misidentification — including many of the estimated 160,900 adverse events that occur in U. To ensure fast and accurate testing, KGH has been focused on reducing the number of specimen collection and labeling errors being made. The use of barcode labels is a simple but powerful way to significantly reduce or eliminate mismatching errors. [ PubMed ] [ Google Scholar ]. Phlebotomists can make any number of errors that compromise specimen integrity in ways that clinical laboratories cannot detect during the testing phase. labeling, and ends with specimen transportation to the laboratory (Plebani, 2007). 45; IQI: −83. Accurate labeling at the point of care can prevent many specimen identification errors and resulting problems. To ensure fast and accurate testing, KGH has been focused on reducing the number of specimen collection and labeling errors being made. Another, Patient Identification, addresses measures to minimize patient-identification mistakes, including those related to specimen labeling. dramatically reduce labeling errors by allowing clinicians to immediately label blood or specimen draws at the bedside. 7% were related to specimen errors, and 58. , emergency, pediatric unit, inpatient, outpatient) and the type of organization (e. Second, label each bin clearly with both product name and bar code number. 11 The majority of labeling errors occurred in biopsy specimens. The close proximity to the patient prevents distractions outside the point of care that can lead to manual errors. This initiative involved the application of. identification errors in laboratory diagnostics. Hill , Darren Mareiniss, Paula Murphy, Heather Gardner, Yu Hsiang Hsieh , Frederick Levy, Gabor D. Proper Labeling of Blood Banks Specimens Every sample must contain: The patient's first and last name. In general, more errors were detected by pathologists (47. 3 - The transfusion service shall accept only those samples that are completely, accurately, and legibly labeled. So is the value of bedside labeling. Labeling errors are also a concern in smaller research labs, where missing specimen information can lead to inefficiency, costing valuable time and sometimes requiring an experiment be redone. You may call or go online. Complying with this standard will help reduce errors by improving specimen handling and tracking, and also reduce lab costs by boosting accuracy and quality. In May 2015 Brigham and Women’s Hospital (BWH) implemented a vendor-based standalone specimen collection product, interfaced to the Electronic Health Record (EHR), to positively identify the right patient to the right specimen order. 18 Issue 9, p104. Provide automatic transmission of reports by computer, pager or other electronic formats: allows transmission of results to relevant medical professionals. 5" Eliminating the delay between when sample labels are produced. This initiative involved the application of radiofrequency identification (RFID) technology to specimen. A study from ECRI Patient Safety Organization found that the majority of errors related to lab testing took place outside the laboratory itself. For example, faulty specimen collection techniques can bump up potassium readings by 1-2 mEq/L. 45; IQI: −83. As a result, a quality improvement initiative was created to reduce the number of specimen-labeling errors. She reported on the outcomes and lessons learned from this unique nine-hospital collaboration at the Lab Quality Confab that took place in San Antonio. Histology errors include slide labeling errors and numerous problems stemming from specimen contamination, while errors in the gross room include incomplete or incorrect gross examination, poorly worded description of the gross examination of a specimen, poor or incorrect sampling of tissue for microscopic analysis, and block mislabeling. 3 APPRAISE: Screen and evaluate evidence. The overall effect of specimen labeling errors often leads to patient safety issues related to. Patient identification. [ PubMed ] [ Google Scholar ]. The labeling process can be reduced to 3 items—the requisition, patient specimen, and specimen label—linked in a way that allows or prohibits errors Figure 4. and specimen labeling is one of the most critical areas for misidentification (Pennsylvania Patient Safety Authority) • 34-58% of total lab errors involve mislabeled specimens, and mis-identification accounted for more laboratory errors than any other source (Bonini et al. (Surgery 2007;141:450-5. Barcode labeling and scanning that closes patient safety gaps. Accurate labeling at the point of care can prevent many specimen identification errors and resulting problems. The reasons for creating processes to prevent specimen labeling errors are clear. Improperly identified specimens can result in delayed diagnosis, additional laboratory testing, treatment of the wrong patient for the wrong disease, and severe transfusion reactions. com Medical Ordering site has been replaced with Cardinal Health Market SM, a new product experience designed with you in mind. To ensure fast and accurate testing, KGH has been focused on reducing the number of specimen collection and labeling errors being made. Order entry errors and misidentification of either the patient or the specimen comprise most of the. HOW TO PREVENT COSTLY MISLABELING AND RECALLS WITH QUICKLABEL DIGITAL LABEL PRINTING Production Floor Decisions. Legacy Health implemented two Cerner tracking solutions to monitor specimens from the time they're collected to the time they're archived. Strategies to reduce the rate of these errors should be a research priority. Specimen Labeling Improper labeling will drastically delay testing and increases mislabels and testing errors. The Clinical Collect rollout, the first of its kind in western Canada, ensures positive patient identification each time a specimen is collected on the unit. The hospital also analyzed specimen identification errors and found that carrying multiple labels into a patient room was the leading cause of specimen mislabeling. The use of barcode labels is a simple but powerful way to significantly reduce or eliminate mismatching errors. Our special report provides tips and the latest advice for how to reduce identification errors in your own healthcare organization. Recognize that laboratories cannot correct specimen handling and labeling errors/deficiencies alone; improvement efforts must be shared with healthcare system leadership in order to effectively address errors/deficiencies generated by non-laboratory staff. The Emergency Department in this leading pediatric level one trauma center was identified as the location for the pilot of the positive patient identification specimen labeling project through barcoding technology. If misidentification is detected, rejection then recollection is the most suitable approach to manage. The 3 images below illustrate ADNPSO's approach to dissecting the aggregate data and associated process steps to identify cause-and-effect relationships. Labeling away from the bedside was the second-leading cause. Lindholm is encouraged to see an uptick in the number of institutions that prohibit the practice of producing and saving specimen. Select the Leica CEREBRO Specimen Tracking System to improve the efficiency of your histology process while securely identifying and tracking patient samples. Medical record number, unique facility number, or date of birth. Establish multidisciplinary teams composed of system-wide representation Do not rule out having a. Here are 3 Best Practices for Reducing Specimen Labeling Errors: 1. Most mislabeling errors are detected when the specimen and. Specimen labeling errors continue to be a significant area of concern for lab. As a result, a quality improvement initiative was created to reduce the number of specimen-labeling errors. Significant reduction of laboratory specimen labeling errors by implementation of an electronic ordering system paired with a bar-code specimen labeling process Peter M. The ability to create specimen labels on demand with mobile printing technology, at a patient's bedside, could significantly reduce the number of errors made. The labeling process can be reduced to 3 items—the requisition, patient specimen, and specimen label—linked in a way that allows or prohibits errors Figure 4. Properly designed lab labels prevent specimen identification errors. Reduce Errors and Put Patient Safety First with Accurate Specimen Labeling Features and Benefits of Brady Solution • Prints clear legible labels that reduce identification errors • Withstands the tissue process protocols and lasts up to 20 years • Label design and printing software to integrate with LIS for automated printing and tracking. 1 Root cause analyses of specimen mislabeling and loss events have revealed various sources of error, including mix-ups due to specimen and label batching, failure to label specimens, incorrect (wrong patient) specimen labels, manual data entry errors, and loss during transport from collection site to laboratory. Specimen labeling errors accounted for 55. The goal of the Specimen Identification Committee was to reduce Specimen ID errors caused by mislabeled and unlabeled specimens and to decrease the incidence of specimen labeling errors across the organization. " This study used a technology, radio-frequency identification (RFID), to track biopsy specimens taken during gastrointestinal endoscopic procedures and to automate identification. The laboratory staff should aware of all these variables to reduce the errors. Most mislabeling errors are detected when the specimen and. Statistics • Specimen identification errors have been reported to occur at rates of up to 5% (Wager et al. A quality initiative to decrease pathology specimen-labeling errors using radiofrequency identification in a high-volume endoscopy center. 8: 1106-1113). Of these errors, 11 (12%) involved specimens associated with an incor-rect patient assignment. Errors that occur in specimen processing include: >Prioritization errors >Data entry errors >Waiting an hour before processing a blood gas specimen >Errors in entering data from a requisition into the LIS you should suspect that there may be other issues related to specimen labeling. Hold all testing until you're able to resolve the issue. This committee was designed to help reduce specimen collection errors and to help update the nursing staff members and teach them the appropriate ways to avoid specimen collection errors. The ePPID near‐patient labeling technology must be integrated and designed for the local hospital environment and. Kahn: Specimen mislabeling: A significant and costly cause of potentially serious medical errors Article downloaded from acutecaretesting. Further data from subset of four studies showed a significant decrease in specimen labeling errors after the institution of the standardized specimen labeling protocols (Median relative percent decrease in specimen labeling errors: −72. Daniel Letinsky, Christina. The article offers information on a collaboration sponsored by the Pennsylvania Patient Safety Authority (PPSA) to help reduce the labeling errors of hospitals for blood specimens. All samples MUST be labeled with ALL of the following information: a. Methods All patient specimen identification errors that occurred in the outpatient department (OPD), emergency department (ED), and inpatient department (IPD) of a 3,800-bed academic medical center in Taiwan were. So is the value of bedside labeling. y The distribution of labeling errors by tissue and specimen type reflected the distribution of case types received in surgical pathology. There is, however, a direct, effective way to drastically reduce specimen-label errors: barcode labeling of blood and other samples at the time they are collected, in the presence of the patient, using a networked PDA device or mobile PC and a mobile printer. Specimen Labeling Errors Put Hospital Patients at Risk. Barcode labeling and scanning that closes patient safety gaps. ReSultS: There have been zero specimen labeling errors using MobiLab since it went live. 03/27/2020. ALWAYS label the sample at the patient’s side to prevent patient and specimen mix ups 7. 5 percent of identification errors in a study conducted by the College of American Pathologists. Misidentification, Mismatch, Illegible, and No Label. Approximately two in every 1000 medical reports don't go to the right patient 3 and one in every 1000 cases are affected by mislabeling. Article downloaded from acutecaretesting. Strategies to reduce the rate of these errors should be a research priority. As a result, an initiative was created to reduce the number of specimen-labeling errors. This is a positive step toward helping reduce the rate of mislabeled specimens—making sure that that first sample, which you're going to compare subsequent samples to, is the correct type. Reduce Specimen Misidentification Errors With Bar Code Point Of Care Labeling. Background Accurate patient identification and specimen labeling at the time of collection are crucial steps in the prevention of medical errors, thereby improving patient safety. com Medical Ordering site has been replaced with Cardinal Health Market SM, a new product experience designed with you in mind. Barcode labeling and scanning that closes patient safety gaps. dramatically reduce labeling errors by allowing clinicians to immediately label blood or specimen draws at the bedside. Whether the label is hand written or preprinted, To reduce errors, please verify specimen handling. Effectiveness of Laboratory Practices to Reducing Patient Misidentification Due to Specimen Labeling Errors at the Time of Specimen Collection in Healthcare Settings: LMBP Systematic Review. For example, to prevent errors during collection and processing, avoid having specimens from multiple patients in the active work area at the same time. If misidentification is detected, rejection then recollection is the most suitable approach to manage. There is, however, a direct, effective way to drastically reduce specimen-label errors: barcode labeling of blood and other samples at the time they are collected, in the presence of the patient, using a networked PDA device or mobile PC and a mobile printer. JavaScript seems to be disabled in your browser. Since 2004, MobiLab has helped more than 200 hospitals and health systems eliminate patient identification and specimen labeling errors, improve turnaround times, and increase efficiencies during the specimen collection process. Collector's ID (may be in LIS only). to print-on-demand and administer specimen labeling directly where it's needed most — with the patient — at almost any point of care location. org staff member may deviate from proper and generally accepted practices. Barcode labeling and scanning that closes patient safety gaps. In the United States, between 0. Common examples of general specimen labeling errors and their causes include:. with barcode technology to reduce risk and improve patient safety and satisfaction. As a result, a quality improvement initiative was created to reduce the number of specimen-labeling errors. Video produced by Valley Medical Center to illustrate the importance of proper specimen labeling. Significant reduction of laboratory specimen labeling errors by implementation of an electronic ordering system paired with a bar-code specimen labeling process Peter M. Date and time of specimen collection e. Labeling errors can lead to possible serious misinterpretation of test results when specimens with similar identifying information enter an environment where thousands of specimens are handled each day and results must be accurately associated with your patient among the many. 1 While this is a cumulative statistic, errors made in patient and specimen identification, labeling, and handling certainly can lead to diagnosis or treatment errors, as well as erosion of trust from providers, patients, and their families and inappropriate. The diagnostic test must be ordered electronically to eliminate the need for a paper requisition to mitigate the risk of errors where the label on the blood sample and the label on the requisition are from different patients. Hospital lab errors can result in incorrect diagnoses that endanger patients. and specimen labeling is one of the most critical areas for misidentification (Pennsylvania Patient Safety Authority) • 34-58% of total lab errors involve mislabeled specimens, and mis-identification accounted for more laboratory errors than any other source (Bonini et al. Phlebotomists also are required to confirm a. Proper Labeling of Blood Banks Specimens Every sample must contain: The patient's first and last name. Specimen labeling errors within the laboratory can occur. (Surgery 2007;141:450-5. ” Booth was the leader of this effort at her hospital. handling as well as these keywords: barcode/bar-code/bar code, labeling errors, laboratory/ ies, methods/strategy(ies) reduce patient specimen handling practice/identification errors, patient identification systems errors, pharmaceutical, specimen, and transfusion. Indeed, it is a daily fact of life in anatomic pathology laboratories that errors do happen in the labeling and identification of tissue specimens. Select the Leica CEREBRO Specimen Tracking System to improve the efficiency of your histology process while securely identifying and tracking patient samples. Most labeling errors have been due to either the wrong patient label or no label being affi xed to a specimen bottle. Most mislabeling errors are detected by one of two methods (patient identifiers and delta checking, described below), and overall only 15% of mislabeled specimens result in the release of a laboratory result—in other words, 85% are detected before the specimen is run and released. , academic institution, private clinic). Phlebotomists also are required to confirm a. Hill , Darren Mareiniss, Paula Murphy, Heather Gardner, Yu Hsiang Hsieh , Frederick Levy, Gabor D. Specimen labeling errors accounted for 55. Establish multidisciplinary teams composed of system-wide representation Do not rule out having a. This allows the ED staff to properly collect virtually all specimens as part of their normal workflow. —Proper specimen identification and labeling is a critical preanalytic step in pretransfusion compatibility testing. To reduce such errors, the following series of strategies were implemented: a restrictive specimen acceptance policy for the ED and IPD in 2006; a computer-assisted barcode positive patient identification system for the ED and IPD in 2007 and 2010, and automated sample labeling combined with electronic identification systems introduced to the. Strategies to reduce the rate of these errors should be a research priority. This initiative involved the application of radiofrequency identification (RFID) technology to specimen. Over the course of our process improvement project designed to reduce or eliminate specimen labeling errors, one prominent indicator was the lack of a defined, systematic process for how and when to identify patients during the course of a visit, and how specimens should be labeled. Nelson, MDa Durham, North Carolina, and San Antonio, Texas Background: There is an increased risk of specimen labeling errors with the generation of a. The diagnostic test must be ordered electronically to eliminate the need for a paper requisition to mitigate the risk of errors where the label on the blood sample and the label on the requisition are from different patients. 18 In addition to implementing labeling poli-ciesandeducatingstaff,perhapsthestrongest intervention to reduce labeling errors is the addition of barcode technology. Patients first name and surname c. Reduction in specimen labeling errors after implementation of a positive patient identification system in phlebotomy. What is the most common cause of these errors? Poor communication and miscommunication among health care workers. After double-checking identification information for the patient, attach the label to the container in the patient's presence. Staff must label the specimen containers at the time of collection in. According to the literature, unrecognized, mislabeled surgical specimens are a common occurrence and a patient safety concern. It has been estimated that N2000 clinical laboratories worldwide use total or subtotal automation supporting pre-analytic activities, with a high rate of increase compared to 2007; the need to reduce errors seems to be the catalyst for increasing the use of robotics. Reduce Errors and Put Patient Safety First with Accurate Specimen Labeling Features and Benefits of Brady Solution • Prints clear legible labels that reduce identification errors • Withstands the tissue process protocols and lasts up to 20 years • Label design and printing software to integrate with LIS for automated printing and tracking. Common examples of general specimen labeling errors and their causes include:. This preanalytical activity typically entails attaching to the primary blood tube an adhesive paper label, which contains demographic data, specific information about the tests that will be performed on that sample along with other potentially useful data. Click here to read the full article: "Specimen Errors Put. Ongoing staff in-service training and competency assessment are important aspects of reducing specimen labeling errors. 45; IQI: −83. The use of information technology for data entry, automated systems for patient identification and specimen labeling, as well as two or more identifiers during sample collection are important steps to reduce misidentification [54, 55] (Fig. 11 The majority of labeling errors occurred in biopsy specimens. Automation through pre-analytical robotic workstations, specimen labelers, specimen management systems, and automated phlebotomy tray preparation can significantly reduce the rate of errors that are due to active human factors. Staff must label the specimen containers at the time of collection in. Examine evidence demonstrating that specimens with minor labeling errors are at increased risk for wrong blood in tube (WBIT) errors. , emergency, pediatric unit, inpatient, outpatient) and the type of organization (e. Summary of LMBP ™ Findings and Recommendations. Most labeling errors have been due to either the wrong patient label or no label being affixed to a specimen bottle. The project involved incorporating specimen. Top ten tips for reducing sample collection errors 1. 5 percent of identification errors in a study conducted by the College of American Pathologists. Abstract: BACKGROUND: Specimen labeling errors have long plagued the laboratory industry putting patients at risk of transfusion-related death, medication. The Clinical Collect rollout, the first of its kind in western Canada, ensures positive patient identification each time a specimen is collected on the unit. —To gather baseline data for specimen mislabeling, specifically targeting major mislabeling events, and to design and implement a plan of corrective action. Preanalytic errors (those oc-curring before the sample or speci-men is analyzed) account for 60% to 75% of all lab errors. 4% errors were of other modalities. The reasons for creating processes to prevent specimen labeling errors are clear. The project was intended to be a broader demonstration of the power of Just Culture concepts to dramatically reduce the rate of adverse patient safety events. Summary of LMBP ™ Findings and Recommendations. designed to reduce patient identification and specimen labeling errors, while increasing the productivity of your phlebotomy and nursing staff. Benefiting From Bedside Specimen Labeling Labeling blood and other samples at the time they are collected improves patient safety and helps prevent a host of problems related to misidentification — including many of the estimated 160,900 adverse events that occur in U. Abstract: BACKGROUND: Specimen labeling errors have long plagued the laboratory industry putting patients at risk of transfusion-related death, medication. Reduction in Specimen Labeling Errors After Implementation of a Positive Patient Identification System in Phlebotomy. " This study used a technology, radio-frequency identification (RFID), to track biopsy specimens taken during gastrointestinal endoscopic procedures and to automate identification. Significant reduction of laboratory specimen labeling errors by implementation of an electronic ordering system paired with a bar-code specimen labeling process Peter M. Patient identification errors in anatomic pathology have been estimated to occur in around four out of every 1000 surgical specimens 2. The labeling process can be reduced to 3 items—the requisition, patient specimen, and specimen label—linked in a way that allows or prohibits errors Figure 4. 1232), "The laboratory must establish and follow written policies and procedures that ensure positive identification and optimum integri-ty of a patient's specimen from the time of collection or. Methods All patient specimen identification errors that occurred in the outpatient department (OPD), emergency department (ED), and inpatient department (IPD) of a 3,800-bed academic medical center in Taiwan were. Date of birth d. — Facilitate interhospital communication and collaboration to reduce blood specimen labeling errors MATERIALS AND METHODS Participants Hospital representatives in the northeast region of Pennsylvania were invited to partici-pate in the Authority collaborative. So is the value of bedside labeling. Hospital lab errors can result in incorrect diagnoses that endanger patients. to print a label for the specimen container that identifies the patient, the specimen type and the test to be performed. and colorectal surgery endoscopy units. • Minimum label requirements: The label should contain date, time and initials of the staff member who collected the This information is vspecimen. Specimen labeling, the most common error, occurred more than twice as much as the second-most. 5 percent of identification errors in a study conducted by the College of American Pathologists. to discuss errors associated with labeling of laboratory specimens. The hospital also analyzed specimen identification errors and found that carrying multiple labels into a patient room was the leading cause of specimen mislabel-ing. As a result, an initiative was created to reduce the number of specimen-labeling errors. being in an electronic format. James Park and Dr. The hospital also analyzed specimen identification errors and found that carrying multiple labels into a patient room was the leading cause of specimen mislabeling. Click here to log in to Cardinal Health Market SM. And these "invisible" errors can cause false results. Common errors included: Mislabeled specimens; Specimens with an incomplete or missing label; Missing or delayed results; Wrong tests. Legacy Health implemented two Cerner tracking solutions to monitor specimens from the time they're collected to the time they're archived. Refer to UCHealth Specimen Labeling policy in the Source. Inclusion criteria were reporting blood specimen. designed to reduce patient identification and specimen labeling errors, while increasing the productivity of your phlebotomy and nursing staff. specimen collection variables (time of collection, fasting status, posture etc) and specimen handling variables (temperature, sunlight, evaporation, labeling, transportation condition etc. Daniel Letinsky, Christina. Phlebotomists can make any number of errors that compromise specimen integrity in ways that clinical laboratories cannot detect during the testing phase. In the United States, between 0. As a result, a quality improvement initiative was created to reduce the number of specimen-labeling errors. 'Wrong blood in tube' (WBIT) errors, where the blood in the tube is not that of the patient identified on the label, may lead to catastrophic outcomes, such as death from ABO‐incompatible red cell transfusion. 1 While this is a cumulative statistic, errors made in patient and specimen identification, labeling, and handling certainly can lead to diagnosis or treatment errors, as well as erosion of trust from providers, patients, and their families and inappropriate. Having to recollect a hemolyzed specimen that is incapable of rendering accurate and useful results to the physician delays treatment, diagnosis, and/or much-needed medications. 8: 1106-1113). Labels can increase efficiency; improve accuracy; reduce errors; and enable a scientific community to share data, resources and learnings. Staff has access to real-time data, test requests, and changes to patient status. and their potential effect on patients, the rate of surgical specimen identification errors may be an important measure of patient safety. The legacy Cardinal. a specimen is analyzed • Up to 75% of all testing errors occur in the Patient stability. , was able to reduce 44 of 63 steps in its phlebotomy collection process where errors could occur. Preanalytic errors (those oc-curring before the sample or speci-men is analyzed) account for 60% to 75% of all lab errors. After six months, the hospital reported it had zero misidentified patients and specimens, zero incorrect specimen containers, and zero unnecessary phlebotomies after six months and 8,000 phlebotomies. Accurate item labeling must be enforced to provide easier communication, organization and a safe working environment. Specimen labeling still a major risk for ID errors and huge liability Technology, focus on human factors can help Understanding why patients and specimens are misidentified is key to reducing or eliminating errors, and risk managers can make progress by focusing on the human behavioral components of healthcare work. According to the literature, unrecognized, mislabeled surgical specimens are a common occurrence and a patient safety concern. Hemolysis has been reported to be the number one cause of rejected chemistry specimens. Specimen Labeling Improper labeling will drastically delay testing and increases mislabels and testing errors. 2% of all errors occurring in this phase (Plebani, 2006). Date and time of specimen collection e. Proper specimen labeling is required to protect patients from adverse consequences of errors due to improper labeling and to meet laboratory accreditation requirements. If you don't use a perpetual inventory system, you can eliminate errors through good organization and placement. Automation through pre-analytical robotic workstations, specimen labelers, specimen management systems, and automated phlebotomy tray preparation can significantly reduce the rate of errors that are due to active human factors. Staff shouldn't label containers until the specimen's been collected. hospitals annually due to sample identification errors, with 55% of all specimen ID errors stemming from a primary specimen. mens and detected 91 errors in specimen labeling. Proper identification helps to insure that each patient receives the correct laboratory results a nd diagnosis. By addressing patient safety and accurate specimen labeling, the Joint Commission’s Laboratory National Patient Safety Goals aims to reduce the amount of specimen labeling errors. EDUCATIONAL COMMENTARY - PREVENTING PRE-ANALYTIC LABORATORY ERRORS (cont. Automation through pre-analytical robotic workstations, specimen labelers, specimen management systems, and automated phlebotomy tray preparation can significantly reduce the rate of errors that are due to active human factors. The odds ratio for 9 of the 10 barcoding system studies exceeded 2. A 2016 study published in the American Journal of Clinical Pathology found that errors in specimen labeling and collection or missing specimens at New York-based Northwell Health Labs could cost. The ePPID near‐patient labeling technology must be integrated and designed for the local hospital environment and. the label is then applied right at patient bedside for the just-in-time, real-time labeling that ensures the right specimen is always matched to the right patient — no errors. Phlebotomists can make any number of errors that compromise specimen integrity in ways that clinical laboratories cannot detect during the testing phase. NHS number or other unique identity number b. Improving patient safety and reducing specimen errors continue to be top priorities among laboratories, with 90% of surveyed labs stating specimen labeling errors are a key concern for their labs. Date of birth d. ) From the Departments of Surgery,a Surgical Pathology,b and Anesthesiology,c Center for Surgical Outcomes. Since 2004, MobiLab has helped more than 200 hospitals and health systems eliminate patient identification and specimen labeling errors, improve turnaround times, and increase efficiencies during the specimen collection process. Wrong-patient errors occur in virtually all stages of diagnosis and treatment. Labeling Templates • Specimen Labels, Avery 5160 • Every specimen submitted must be labeled! 8 Large Specimen Labels (Tissue/Pathologic Specimens) Small Specimen Labels - Pharmacokinetics (PK) Small Specimen Labels (Fresh/Frozen Liquids) Hint: Cut here to reduce label size. The objective of this review was to identify and evaluate the effectiveness of laboratory practices/ interventions to develop evidence based recommendations for the best laboratory practices to reduce labeling errors” Sandhu et al (2017). Ensure that all samples contain at least 2 unique identifiers and the information on the sample matches the information on the requisition. specimen labeling errors, and 22% were. As summarized in Table 1, the evidence of practice effectiveness for reducing ID errors indicates a consistent improvement associated with barcoding systems compared to non-barcoding practices with a high strength of evidence in hospital settings. 18 In addition to implementing labeling poli-ciesandeducatingstaff,perhapsthestrongest intervention to reduce labeling errors is the addition of barcode technology. Select the Cognitive Cxi for on-demand slide labeling at the workstation. Methods All patient specimen identification errors that occurred in the outpatient department (OPD), emergency department (ED), and inpatient department (IPD) of a 3,800-bed academic medical center in Taiwan were. Common examples of general specimen labeling errors and their causes include:. labeling, and ends with specimen transportation to the laboratory (Plebani, 2007). -Specimen collection, labeling, storage and transport instructions -Specimen rejection criteria • Laboratories should provide specific feedback to individual healthcare providers regarding problems with the quality of specimens received and provide recommendations for improvement 4. and their potential effect on patients, the rate of surgical specimen identification errors may be an important measure of patient safety. With pre-printed labels, a color-coding system to match medication containers to corresponding syringes, a TIME-OUT™ marker and Correct Specimen Zone™, the Correct Medication Labeling System contains everything needed to label medication on the. Initials or signature of the specimen collector 8. [ PubMed ] [ Google Scholar ]. 8 The Food and Drug Administration has proposed bar-. This initiative involved the application of. It's also a daily time-saver for phlebotomists and other staff tasked with collecting specimens, since up-to-date information about what to draw and in what order appears automatically on their device. handling as well as these keywords: barcode/bar-code/bar code, labeling errors, laboratory/ ies, methods/strategy(ies) reduce patient specimen handling practice/identification errors, patient identification systems errors, pharmaceutical, specimen, and transfusion. Date of birth d. Centrifugation of Serum Separator Tubes. Common errors included: Mislabeled specimens; Specimens with an incomplete or missing label; Missing or delayed results; Wrong tests. It plans on using a patient verifying system along with two separate unique patient identifiers to reduce the number of mistakes. Automation through pre-analytical robotic workstations, specimen labelers, specimen management systems, and automated phlebotomy tray preparation can significantly reduce the rate of errors that are due to active human factors. This initiative involved the application of radiofrequency identification (RFID) technology to specimen. " For his part, Dr. “Thus, to reduce blood specimen labeling errors, in 2009, the authority asked hospitals to address this issue in a collaborative project. (Surgery 2007;141:450-5. Errors can be caused by: Lack of patient identification and/or sample labeling Transcription errors due to manual data entry Lack of a procedure for identifying patient and samples Errors can lead to: Noncompliance Misdiagnosis Incorrect treatment of a patient Need for resampling Lost billing opportunities. Most labeling errors have been due to either the wrong patient label or no label being affi xed to a specimen bottle. To reduce such errors, the following series of strategies were implemented: a restrictive specimen acceptance policy for the ED and IPD in 2006; a computer-assisted barcode positive patient identification system for the ED and IPD in 2007 and 2010, and automated sample labeling combined with electronic identification systems introduced to the. The use of information technology for data entry, automated systems for patient identification and specimen labeling, as well as two or more identifiers during sample collection are important steps to reduce misidentification [54, 55] (Fig. Prospectus for Decreasing Lab Specimen Errors 2 Abstract It has been estimated that >160,000 adverse patient events occur each year in the United States because of patient or specimen identification errors involving the laboratory (Sandhu, et. Specimen Labeling •Positive patient identification and strict adherence to policies and procedures is imperative throughout the process of collecting and labeling specimens to help assure patient safety. 03/27/2020. Reduction in Specimen Labeling Errors After Implementation of a Positive Patient Identification System in Phlebotomy. The Washington Post announced in May of 2016 that medical errors had become the third leading cause of death in the United States. This product used bar code technology as an intervention to reduce specimen labeling errors. LABELING ERRORS FORCE THE NEED FOR RE-COLLECTION OF SPECIMENS CAUSING POTENTIAL DELAYS IN CARE UPMC Shadyside 23 Post‐Process Improvement Labeling Errors DOES NOT OCCUR •Specimens are collected utilizing bedside technology with auto‐ generated collector identification,. Improving patient safety and reducing specimen errors continue to be top priorities among laboratories, with 90% of surveyed labs stating specimen labeling errors are a key concern for their labs. Common examples of general specimen labeling errors and their causes include:. Bar code specimen labeling at the point of care significantly improves patient safety by reducing misidentification errors. 5 percent of identification errors in a study conducted by the College of American Pathologists. This initiative to share best practices incorporated techniques that were refined in other projects designed to reduce medical errors and improve patient care. This is a positive step toward helping reduce the rate of mislabeled specimens—making sure that that first sample, which you're going to compare subsequent samples to, is the correct type. ALWAYS label the sample at the patient's side to prevent patient and specimen c. After six months, the hospital reported it had zero misidentified patients and specimens, zero incorrect specimen containers, and zero unnecessary phlebotomies after six months and 8,000 phlebotomies. Centrifugation of Serum Separator Tubes. An inaccurately labeled specimen can lead to patient harm or “near-miss” situations that could cause emotional trauma to a patient. Given that one study found a whopping one-third (37%) of specimen labeling errors lead to adverse events, it’s no wonder that risk-averse healthcare providers have strict procedures for specimen collection, handling and processing centered firmly on “identification. Lab technicians have known for decades that the process of identifying and tracking specimen cassettes and slides is not an accurate science. By utilizing wireless handheld and printer technology, MobiLab is. 1% and 5% of specimens are mismatched during the collection process. Specimen Labeling Workflow The specimen labeling workflow is as follows with the addition at Step 11: Pre- Procedure 1) Verify orders. Of these errors, 11 (12%) involved specimens associated with an incor-rect patient assignment. Medical record number, unique facility number, or date of birth. Further data from subset of four studies showed a significant decrease in specimen labeling errors after the institution of the standardized specimen labeling protocols (Median relative percent decrease in specimen labeling errors: −72. Accurate labeling at the point of care can prevent many specimen identification errors and resulting problems. She reported on the outcomes and lessons learned from this unique nine-hospital collaboration at the Lab Quality Confab that took place in San Antonio. Blood specimen rejection rates in this phase have been the subject of many studies and remain an issue of concern with some studies finding up to 68. The reasons for creating processes to prevent specimen labeling errors are clear. Kelen GD: Significant reduction of laboratory spe-cimen labeling errors by implementation of an electronic ordering system paired with a bar-code specimen labeling process. Am J Clin Pathol 2010; 133 ( 6 ):870-877. Specimen labeling, the most common error, occurred more than twice as much as the second-most. Barcode labeling and scanning that closes patient safety gaps. The nurse scans a special barcode on the patient's armband and prints a patient-specific label right at the bedside, helping to eliminate specimen labeling errors. , emergency, pediatric unit, inpatient, outpatient) and the type of organization (e. identification errors in laboratory diagnostics. By utilizing wireless handheld and printer technology at the bedside, Mobi Lab is designed to reduce patient identification and specimen labeling errors, while increasing the productivity of your. All of them are important as they help decide the next steps in a patient's care plan. , was able to reduce 44 of 63 steps in its phlebotomy collection process where errors could occur. 5 percent of identification errors in a study conducted by the College of American Pathologists. The Clinical Collect rollout, the first of its kind in western Canada, ensures positive patient identification each time a specimen is collected on the unit. Specimen labeling errors accounted for 55. •The majority of specimen labeling errors are the direct result of deviations from Standard Operating Procedures. Many laboratory processes, such as specimen labeling, specimen transport, and test results reporting, are good candidates for FMEA. The odds ratio for 9 of the 10 barcoding system studies exceeded 2. JavaScript seems to be disabled in your browser. With such a system in place, you have a complete bedside specimen labeling solution. technology can markedly reduce misidentification and specimen mislabeling errors. Daniel Letinsky, Christina. Since 2004, MobiLab has helped more than 200 hospitals and health systems eliminate patient identification and specimen labeling errors, improve turnaround times, and increase efficiencies during the specimen collection process. Label samples correctly. Bar-coding. The project involved incorporating specimen. Every day hundreds of specimens from patients are sent to our clinical laboratories for testing. Improperly identified specimens can result in delayed diagnosis, additional laboratory testing, treatment of the wrong patient for the wrong disease, and severe transfusion reactions. Legacy Health implemented two Cerner tracking solutions to monitor specimens from the time they're collected to the time they're archived. Given that one study found a whopping one-third (37%) of specimen labeling errors lead to adverse events, it's no wonder that risk-averse healthcare providers have strict procedures for specimen collection, handling and processing centered firmly on "identification. This preanalytical activity typically entails attaching to the primary blood tube an adhesive paper label, which contains demographic data, specific information about the tests that will be performed on that sample along with other potentially useful data. Date of birth d. Most mislabeling errors are detected by one of two methods (patient identifiers and delta checking, described below), and overall only 15% of mislabeled specimens result in the release of a laboratory result—in other words, 85% are detected before the specimen is run and released. reducing patient specimen and laboratory testing identification errors. Significant reduction of laboratory specimen labeling errors by implementation of an electronic ordering system paired with a bar-code specimen labeling process Peter M. The Washington Post announced in May of 2016 that medical errors had become the third leading cause of death in the United States. org staff member may deviate from proper and generally accepted practices. 8 Specimen labeling, the most common error, occurred more than twice as much as the second-most common cause. Date and time drawn (may be in LIS only). Dasco Learning Center. —To gather baseline data for specimen mislabeling, specifically targeting major mislabeling events, and to design and implement a plan of corrective action. Ultimately, Hwang said, manufactures need to change labeling to correct the problem. 5% of identification errors ("Identification Errors Involving Clinical Laboratories: A College of American Pathologists Q-Probes Study of Patient and Specimen Identification Errors at 120 Institutions," Archives of Pathology and Laboratory Medicine, 2006; Vol. 'Wrong blood in tube' (WBIT) errors, where the blood in the tube is not that of the patient identified on the label, may lead to catastrophic outcomes, such as death from ABO‐incompatible red cell transfusion. specimen labels can significantly reduce ED specimen-related errors, with. To reduce such errors, the following series of strategies were implemented: a restrictive specimen acceptance policy for the ED and IPD in 2006; a computer-assisted barcode positive patient identification system for the ED and IPD in 2007 and 2010, and automated sample labeling combined with electronic identification systems introduced to the OPD in 2009. Since 2004, MobiLab has helped more than 200 hospitals and health systems eliminate patient identification and specimen labeling errors, improve turnaround times, and increase efficiencies during the specimen collection process. After six months, the hospital reported it had zero misidentified patients and specimens, zero incorrect specimen containers, and zero unnecessary phlebotomies after six months and 8,000 phlebotomies. Kahn: Specimen mislabeling: A significant and costly cause of potentially serious medical errors Article downloaded from acutecaretesting. 1553 x237 to find out how you can improve sample collection and identification. Participate in the proper labeling of the specimen. Patient identification. For example, to prevent errors during collection and processing, avoid having specimens from multiple patients in the active work area at the same time. Click here to read the full article: "Specimen Errors Put. It has been estimated that N2000 clinical laboratories worldwide use total or subtotal automation supporting pre-analytic activities, with a high rate of increase compared to 2007; the need to reduce errors seems to be the catalyst for increasing the use of robotics. Our experts can lead you to the labeling system right for your business. Specimen labeling still a major risk for ID errors, can lead to huge liability. Accurate item labeling must be enforced to provide easier communication, organization and a safe working environment. Specimen-labeling concerns at the facility necessitated a quality improvement program to correct errors related to wrong-patient labels, typographical errors and specimen bottles sent to the pathology lab without labels, says Dawn Francis, MD, a Mayo gastroenterologist and the study's lead author. Always label specimens while still in the presence of the patient/at the bedside. 8 The Food and Drug Administration has proposed bar-. Annals of Emergency Medicine. Nurses must take additional precautions when administering medications that come in bottles that can easily be confused. The 3 images below illustrate ADNPSO's approach to dissecting the aggregate data and associated process steps to identify cause-and-effect relationships. In this way, the adoption and implementation of Auto12 will reduce the human errors currently associated with the lack of standardisation of labels on clinical laboratory specimens. A weak link between the requisition and patient specimen allows one to start with patient A’s requisition and draw a specimen from patient B, making “specimen-requisition mismatch” and “wrong-blood-in-tube” errors possible. To ensure fast and accurate testing, KGH has been focused on reducing the number of specimen collection and labeling errors being made. 5 ways to reduce medical errors associated with lab specimens To help remedy patient misidentification and specimen labeling errors, the report recommends setting up a bar code identification. Examine evidence demonstrating that specimens with minor labeling errors are at increased risk for wrong blood in tube (WBIT) errors. Specimen labeling errors may be prevented by adhering to appropriate policies as well as unique educational programs, marketing strategies and other techniques. a specimen is analyzed • Up to 75% of all testing errors occur in the Patient stability. ALWAYS verify the accuracy of specimen labelling before you or the patient leaves the. Complying with this standard will help reduce errors by improving specimen handling and tracking, and also reduce lab costs by boosting accuracy and quality. The following methods were utilized by staff on the Progressive Coronary Care Unit as a part of this collaborative: LabeL maNagemeNt - minimize opportunity for wrong label on a specimen • Change label printing from 'ICU style-at time of order entry' to hourly. Nurses must take additional precautions when administering medications that come in bottles that can easily be confused. 3 - The transfusion service shall accept only those samples that are completely, accurately, and legibly labeled. (Surgery 2007;141:450-5. The need for proper identification is specified by the College of American. Body of evidence qualitative analysis. CEO SUMMARY: In this unusual collaboration, the participating Pennsylvania hospitals dramatically reduced blood specimen labeling errors. Since 2004, MobiLab has helped more than 200 hospitals and health systems eliminate patient identification and specimen labeling errors, improve turnaround times, and increase efficiencies during the specimen collection process. 4%) than by clinicians (22%). The Washington Post announced in May of 2016 that medical errors had become the third leading cause of death in the United States. Fortunately, barcode specimen collection can virtually eliminate patient identification and specimen labeling errors during collection by removing all of the potential failure points. Diagnosing Specimen Collection Issues Identifying specimen collection issues and learning how to prevent them Ken Curtis, BS, PBT (ASCP) •Labeling Errors •Missing Date and Time •Missing phlebotomist initials •Incomplete Label • Missing part of name, DOB, MRN • Illegible. HOW TO PREVENT COSTLY MISLABELING AND RECALLS WITH QUICKLABEL DIGITAL LABEL PRINTING Production Floor Decisions. It is also recognized that contamination during processing is another way the integrity of a patient's tissue specimen can be compromised. Specimen Labeling •Positive patient identification and strict adherence to policies and procedures is imperative throughout the process of collecting and labeling specimens to help assure patient safety. Blood Bag Labeling That. This product used bar code technology as an intervention to reduce specimen labeling errors. The nurse scans a special barcode on the patient's armband and prints a patient-specific label right at the bedside, helping to eliminate specimen labeling errors. Kim, MD,a Bert Dotson, MBA, HTL(ASCP),b Sean Thomas, MD,a,c and Kelly C. Reduce Errors and Put Patient Safety First with Accurate Specimen Labeling Features and Benefits of Brady Solution • Prints clear legible labels that reduce identification errors • Withstands the tissue process protocols and lasts up to 20 years • Label design and printing software to integrate with LIS for automated printing and tracking. Wagar EA, Stankovic AK, Raab S, et al. // Healthcare Benchmarks & Quality Improvement;Sep2011, Vol. 4% errors were of other modalities. With such a system in place, you have a complete bedside specimen labeling solution. AABB Standards and How They Apply to Blood Bank Pretransfusion (31st Edition BBTS) • 5. Abstract: BACKGROUND: Specimen labeling errors have long plagued the laboratory industry putting patients at risk of transfusion-related death, medication. Lastly, when replaced in its cradle, the BD. Process Improvements Help Hospital Reduce Specimen-Label Errors Huge numbers of patients, medications, specimens and test results circulate through a hospital, so it is critical that all of them be properly identified. The need for proper identification is specified by the College of American. Specimen labeling still a major risk for ID errors, can lead to huge liability. Specimen labeling errors accounted for 55. Used by nurses, phlebotomists and other healthcare professionals, Sunquest Collect™, a clinical specimen collection solution, brings the laboratory to the point-of-care. when do nurses make laboratory errors? Actually, we make them fairly often—typically by using im - proper technique when collecting and handling samples and speci-mens. What is the most common cause of these errors? Poor communication and miscommunication among health care workers. 1% and 5% of specimens are mismatched during the collection process. handling as well as these keywords: barcode/bar-code/bar code, labeling errors, laboratory/ ies, methods/strategy(ies) reduce patient specimen handling practice/identification errors, patient identification systems errors, pharmaceutical, specimen, and transfusion. Bar code specimen labeling at the point of care significantly improves patient safety by reducing misidentification errors. Properly designed lab labels prevent specimen identification errors. And these "invisible" errors can cause false results. ADVANCE Healthcare Network has published a new article by Linda Trask & Amy McKibbin of Iatric Systems, explaining how leading hospitals are reducing the risk of medical errors, especially in the ED. org Stephen E. A study from ECRI Patient Safety Organization found that the majority of errors related to lab testing took place outside the laboratory itself. prevent many specimen identification errors and resulting problems. It's also a daily time-saver for phlebotomists and other staff tasked with collecting specimens, since up-to-date information about what to draw and in what order appears automatically on their device. The Valley Hospital in Ridgewood, N. Significant reduction of laboratory specimen labeling errors by implementation of an electronic ordering system paired with a bar-code specimen labeling process Peter M. The goal of the Specimen Identification Committee was to reduce Specimen ID errors caused by mislabeled and unlabeled specimens and to decrease the incidence of specimen labeling errors across the organization. Surgical specimen errors were defined in all stages of the SPSM process, in the intraoperative phase during specimen ordering (8%), labeling (6%), containment (4%), transport or storage (40%), and collection. This initiative to share best practices incorporated techniques that were refined in other projects designed to reduce medical errors and improve patient care. CONCLUSION: Combining an electronic physician order entry with bar-coded patient verification and electronic documentation and information system-generated specimen labels can significantly reduce ED specimen-related errors, with sizable influence on institutional specimen-related errors. Participate in the proper labeling of the specimen. By addressing patient safety and accurate specimen labeling, the Joint Commission's Laboratory National Patient Safety Goals aims to reduce the amount of specimen labeling errors. On the basis of a high overall strength of evidence of effectiveness, barcoding systems for specimen labeling and point-of-care test barcoding are recommended as best practices to reduce identification errors and improve the accuracy of patient specimen and laboratory testing identification in hospital settings. 5 percent of identification errors in a study conducted by the College of American Pathologists. Fortunately, barcode specimen collection can virtually eliminate patient identification and specimen labeling errors during collection by removing all of the potential failure points. What is the most common cause of these errors? Poor communication and miscommunication among health care workers. Reduce Errors and Put Patient Safety First with Accurate Specimen Labeling Features and Benefits of Brady Solution • Prints clear legible labels that reduce identification errors • Withstands the tissue process protocols and lasts up to 20 years • Label design and printing software to integrate with LIS for automated printing and tracking. Reduction in specimen labeling errors after implementation of a positive patient identification system in phlebotomy. Kelen GD: Significant reduction of laboratory spe-cimen labeling errors by implementation of an electronic ordering system paired with a bar-code specimen labeling process. The Washington Post announced in May of 2016 that medical errors had become the third leading cause of death in the United States. Labels can increase efficiency; improve accuracy; reduce errors; and enable a scientific community to share data, resources and learnings. 1 While this is a cumulative statistic, errors made in patient and specimen identification, labeling, and handling certainly can lead to diagnosis or treatment errors, as well as erosion of trust from providers, patients, and their families and inappropriate. You may call or go online. Reduce Specimen Misidentification Errors With Bar Code Point Of Care Labeling. Used by nurses, phlebotomists and other healthcare professionals, Sunquest Collect™, a clinical specimen collection solution, brings the laboratory to the point-of-care. There is, however, a direct, effective way to drastically reduce specimen-label errors: barcode labeling of blood and other samples at the time they are collected, in the presence of the patient, using a networked PDA device or mobile PC and a mobile printer. Lab Uses Barcode Comparator to Reduce Specimen Labeling Errors [Case Study] Large Healthcare Provider in Minnesota Uses Barcode Comparator to Reduce Specimen Labeling View Post. specimen labeling errors, and 22% were. In May 2015 Brigham and Women's Hospital (BWH) implemented a vendor-based standalone specimen collection product, interfaced to the Electronic Health Record (EHR), to positively identify the right patient to the right specimen order. To ensure fast and accurate testing, KGH has been focused on reducing the number of specimen collection and labeling errors being made. In general, more errors were detected by pathologists (47. An inaccurately labeled specimen can lead to patient harm or “near-miss” situations that could cause emotional trauma to a patient. Specimen labeling errors within the laboratory can occur. technology can markedly reduce misidentification and specimen mislabeling errors. By utilizing wireless handheld and printer technology at the bedside, Mobi Lab is designed to reduce patient identification and specimen labeling errors, while increasing the productivity of your. The ePPID near‐patient labeling technology must be integrated and designed for the local hospital environment and. Most labeling errors have been due to either the wrong patient label or no label being affixed to a specimen bottle. Call us at 801-507-2110 Search our Test Menu. Common examples of general specimen labeling errors and their causes include:. Significant reduction of laboratory specimen labeling errors by implementation of an electronic ordering system paired with a bar-code specimen labeling process Peter M. Common errors included: Mislabeled specimens; Specimens with an incomplete or missing label; Missing or delayed results; Wrong tests. Top ten tips for reducing sample collection errors 1. Radio-frequency Identification Reduces Specimen Labeling Errors Date: October 13, 2008 Source: Mayo Clinic Summary: With a long-held commitment to continuously improving the quality and safety of. Notes Joint Commission. Another, Patient Identification, addresses measures to minimize patient-identification mistakes, including those related to specimen labeling. ReSultS: There have been zero specimen labeling errors using MobiLab since it went live. Proper identification helps to insure that each patient receives the correct laboratory results a nd diagnosis. and their potential effect on patients, the rate of surgical specimen identification errors may be an important measure of patient safety. The labeling process can be reduced to 3 items—the requisition, patient specimen, and specimen label—linked in a way that allows or prohibits errors Figure 4. Additionally, over half of lab contacts surveyed claimed that specimen labeling errors are a significant concern for their labs, with an astounding 92% of Lab Supervisors confirming these findings. (Surgery 2007;141:450-5. Fortunately, barcode specimen collection can virtually eliminate patient identification and specimen labeling errors during collection by removing all of the potential failure points. Label samples correctly. Body of evidence qualitative analysis. Laboratory Medicine Best Practices Workgroup recommends barcoding systems for specimen labeling and point-of-care test barcoding as evidence-based "best practices" with high overall strength. Centrifugation of Serum Separator Tubes. Select the HistoCore PERMA S for direct on-demand slide labeling at the microtome station. Accurate labeling at the point of care can prevent many specimen identification errors and resulting problems. [10] [11] Barcode technologies for specimen collection have been noted to increase patient comfort, decrease possible delays in diagnosis or treatment, and decrease. The Emergency Department in this leading pediatric level one trauma center was identified as the location for the pilot of the positive patient identification specimen labeling project through barcoding technology. All samples MUST be labeled with ALL of the following information: a. Improving patient safety and reducing specimen errors continue to be top priorities among laboratories, with 90% of surveyed labs stating specimen labeling errors are a key concern for their labs. handling as well as these keywords: barcode/bar-code/bar code, labeling errors, laboratory/ ies, methods/strategy(ies) reduce patient specimen handling practice/identification errors, patient identification systems errors, pharmaceutical, specimen, and transfusion. As a result, a quality improvement initiative was created to reduce the number of specimen-labeling errors. Phlebotomists also are required to confirm a. All of them are important as they help decide the next steps in a patient's care plan. The most frequently reported interventions to reduce specimen-labeling error are strict policies (in clinical setting and Blood Bank), education, and two person checks. , emergency, pediatric unit, inpatient, outpatient) and the type of organization (e. 04/07/2020. errors, deployment of the Six Sigma methodology to reduce errors, and testing and implementation of technical solutions to improve patient safety. As a result, an initiative was created to reduce the number of specimen-labeling errors. Every day hundreds of specimens from patients are sent to our clinical laboratories for testing. 3 - The transfusion service shall accept only those samples that are completely, accurately, and legibly labeled. A weak link between the requisition and patient specimen allows one to start with patient A’s requisition and draw a specimen from patient B, making “specimen-requisition mismatch” and “wrong-blood-in-tube” errors possible. Complying with this standard will help reduce errors by improving specimen handling and tracking, and also reduce lab costs by boosting accuracy and quality. Article downloaded from acutecaretesting. The ability to create specimen labels on demand with mobile printing technology, at a patient's bedside, could significantly reduce the number of errors made. As a result, an initiative was created to reduce the number of specimen-labeling errors. She reported on the outcomes and lessons learned from this unique nine-hospital collaboration at the Lab Quality Confab that took place in San Antonio. Ultimately, Hwang said, manufactures need to change labeling to correct the problem. CONCLUSION: Combining an electronic physician order entry with bar-coded patient verification and electronic documentation and information system-generated specimen labels can significantly reduce ED specimen-related errors, with sizable influence on institutional specimen-related errors. 3% were identification errors, 13. On-demand labeling. designed to reduce patient identification and specimen labeling errors, while increasing the productivity of your phlebotomy and nursing staff. Milwaukee, WI (PRWEB) October 28, 2009 Brady Worldwide, Inc. The goal of the collaborative was a 50% reduction in blood specimen labeling errors over 18 months. • Minimum label requirements: The label should contain date, time and initials of the staff member who collected the This information is vspecimen. This means that test-related errors can have serious repercussions. Methods All patient specimen identification errors that occurred in the outpatient department (OPD), emergency department (ED), and inpatient department (IPD) of a 3,800-bed academic medical center in Taiwan were. The deadline for compliance to AUTO12-A, Specimen Labels: Content and Location, Fonts, and. —To gather baseline data for specimen mislabeling, specifically targeting major mislabeling events, and to design and implement a plan of corrective action. Complying with this standard will help reduce errors by improving specimen handling and tracking, and also reduce lab costs by boosting accuracy and quality. org Stephen E. As technology continues to progress and regulatory requirements continue to expand, there's no doubt that laboratories are going to see a number of advancements relating to labeling and identification in. Specimen-labeling concerns at the facility necessitated a quality improvement program to correct errors related to wrong-patient labels, typographical errors and specimen bottles sent to the pathology lab without labels, says Dawn Francis, MD, a Mayo gastroenterologist and the study's lead author. emphasis in the medical community to reduce medical errors due to mislabeled specimens.