WELCOME
davidplaut@yahoo.com
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Two Significant Stats
70 %
40%
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Errors in the Stat Lab:
2007
51, 746 tests performed
393 questionable results (0.7%)
160 confirmed laboratory errors (0.3%)
46 caused inappropriate pt. care (.01%)
24 of these were analytical errors (52%)
These data reflect ‘mistakes’ after those runs with QC rejects
were omitted from the tally. Plebani M, Carraro P. Clin Chem; 2007
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Sample Collection Venipuncture
•
•
•
•
•
•
•
Proper patient identification
Length of time tourniquet is applied
Proper antiseptic to cleanse site
Proper tube;
Proper amount of blood
Proper order of draw
Proper mixing of blood with anticoagulant
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APPLICATION FLOW
 Orders Sent from LIS to Server
 Orders distributed to Handhelds
 View Collection List / Select Patient-Review Inventory
(tubes/tests), Patient History, & Open vs. Collected Draws
 Scan Bracelet - Positive Patient ID
 Collect Specimens
 Print Barcode Specimen Labels at Bedside
 Route Specimens to Lab
 Collection Data Transferred to LIS
 Received-In Specimens are Scanned
Print Label at the Patient’s
Bedside
•
After specimen is collected, user is
prompted to ‘SCAN CONTAINER’
•
Specimen label prints when correct
container bar code is scanned using the
BD Vacutainers.
•
Label applied by aligning notches when
using BD Vacutainers
Strong, Oscar
Reviewing Patients
with Open Orders
W-440-A (Allen, Angelo)
W-442-A (Rodriguez, Carlos)
W-444-B (Johnson, Kimberly)
Viewing Patients
with Open Orders
W-444-B (Johnson, Kimberly)
Blue
Red
PT, PTT
BMP
Some (not all) of the Icons
These icons merely indicate a
specimen
This icon indicates an incomplete order
This icon indicates a missed order –
could not be completed at this time.
Some (more, not all) of the
Icons
This icon indicates a completed order
• This icon indicates a stat request
• This icon indicates a timed sample
that is incomplete at this time
Scanning the
Patient’s Wrist Band
Please ID the Patient by scanning
the correct field
The PT bar code
on the wrist is
scanned to give
the Medical
Record
Number.
Johnson, Kimberly
DOB
4.24.32
Age
79
Sex
F
Bed
W444B
MRN
MHC3579B
FIN
Incorrect PT ID !
The bar code
did not match
the patient’s
financial ID
Order of Draw
1.
Blood culture tube
2.
Sodium citrate (light. blue)
3.
Serum tubes (w/ or w/o clot activator, w/ or w/o
gel separator)
4.
Heparin tubes (green)
5.
EDTA tubes (lavender)
6.
Glycolytic inhibitor (gray)
7.
Revision reflects increased use of plastic tubes
8.
Plastic red top tubes (serum) contain a clot
activator that may interfere with coag. testing
9.
Glass non-additive red top tubes may still be
drawn before the coagulation tube
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Delta Checks
Absolute Delta
Hemoglobin 11/10/07 12.1
11/11/07 9.2 ?
% Delta
Creatinine
08/12/07 0.9
11/13/07 1.2
%
33%
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Johnson and Stelmach Clin. Lab News September, 2007
Delta Checks
Absolute or % Delta
BUN If < 19.9 mg/dL
>20
10 mg/dL
40%
Consider the time between samples,
e.g. 7 d for BUN
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Johnson and Stelmach Clin. Lab News September, 2007
Follow up of rejected data
Once a value is NOT auto-released,
it must be verified.
Repeated?
Discussed with clinician?
Compared with other data
Same patient – different time
Same patient – different tests
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Advantages
• Increases physician confidence
• Ability to Increase Volume without
Increasing Staff
• Enables Further Technologist
Development in Manual Areas
• Provides for Consistent Release of Results
• Reduces TAT and costs
• Reduces frustration
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Thank you !
davidplaut@yahoo.com
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