Laboratory ProceduresClinical

Vanderbilt University Medical Center

Nashville, TN

Department of Pathology

Who to Contact? The Main Lab: 343-9155 (3-9155) Client Services (Reference Tests):

322-4844 (2-4844) Reference test are tests that are sent to an outside facility.

These numbers are resources which you can access at any time for any questions you may have about how a test is drawn, what color tube, etc.

Labels Labels should be

legible. ALL test tubes and

urine cups must be labeled.

Pt’s Name, MR# Required on all specimens

http://vumcpolicies.mc.vanderbilt.edu/E-Manual/Hpolicy.nsf/AllDocs/F575E10C0648EB8686256A6B00502EA9

Requisitions All requisitions require:

Pt’s Full name Pt’s MR number Current date Current Billing Number Doctor’s code Clinic code Doctor’s signature ICD-9 Code(s) Tests ordered clearly

marked

Patient Verification is MANDITORY

Two identifiers should be used Name DOB ID Bracelet (if available)

SSN Government Issue

Driver’s License, ID Card with Picture

Photograph: VPH Medical Record (chart)

http://vumcpolicies.mc.vanderbilt.edu/E-Manual/Hpolicy.nsf/AllDocs/29B5F84E98DB814986256CB5007E4E6D

Causes of Common Labeling Errors

Failure to verify patient properly Not labeling specimens immediately after

drawing specimens Failure to label specimens before leaving

patient’s side.

Effect of Labeling Errors Incorrect laboratory results will be

reported. Delays laboratory results. If detected, specimen may be discarded. Incorrect results may hinder proper patient

care, or even death.

5 Steps to Effective Labeling

1. Verify Patient Identification by 2 identifiers.

2. Match Patient ID to requisition.3. Match Patient ID to Specimen Label(s)4. Label specimen before you leave the

Patient.5. Match the label to Requisition as the

specimen is bagged for transport.

Specimen Packaging Requisition should be folded

so the patient’s name and priority shows through the plastic bag.

Blood tubes and urine specimens should be packed in separate bags.

Blood Cultures should be packed separate from blood tubes.

Requisitions should be inserted in pocket provided separating blood from paperwork.

TUBETUBE

Pt. Info

Priority

Name, Mr#, Billing Code, DR's Code,

Clinic CodePriority

(STAT, Routine)

TUBE

Safety Universal Precautions

at all times PPE’s (Gloves, lab

coats, etc.) Discard sharps properly

ASAP Keep your work area

clean and organized

Tube Order1. Red or Gold top,

(aka SST or Tiger top)Light Green, (Lithium Heparin)

2. Blue top3. Green Heparinized

(dark Green)4. Lavender EDTA

(always last)If a Blood Culture is ordered, draw the blood culture first and collect the rest in the original order.

All tubes should be gently inverted to avoid hemolysis and clotting.

Blue Sodium Citrate Tube If a PT or PTT is ordered by

itself always draw 3 to 5 ml. in a discard tube. (RED or Gold)

These specimens should be sent ASAP.

This tube must always be full.

Tips For Good Customer Service1. Always let patient see you

change gloves.2. Always let the patient see

you taking out new equipment.

3. Always be courteous4. Always maintain a clean

appearance both personally and professionally.

5. Always be confident.

* Remember you are in control.

Tips to Avoid Hemolysis

Use the largest bore needle available whenever possible.

Avoid using syringes to draw blood.

Avoid using Butterfly needle sets. Do not push blood into tubes with

syringes and butterfly needle sets. Make sure the blood is being draw

under the tubes own evacuated system.

Make sure the blood flow into tube is quick and constant.

Always invert tubes (especially tubes with additives).

Who to Contact? The Main Lab: 343-9155 (3-9155) Client Services (Reference Tests):

322-4844 (2-4844) Reference test are tests that are sent to an outside facility.

These numbers are resources which you can access at any time for any questions you may have about how a test is drawn, what color tube, etc.

Serum Vs. Plasma (Fluid Part of The Blood)

Serum No Anti-coagulant Red Top or SST

(Gold Top) Tube.

Plasma Anti-coagulated Lavender Dark Green Top Light Blue

Latex Alternatives Nitrile Gloves Vinyl Gloves Nitrile Tourniquets Cartoon Band aids If all else fails use regular tourniquets over

cloth (Sleeves, Gauze)

Questions and Answers

Star Panel To Access Non- Vanderbilt Patient

Accounts, security needs to be obtained for

VPLS. Contact Security Manager, request SAMS

(Security Access and Maintenance Team) access form for VPLS Security.