Specimen during testing

Using the provided paper, write 5 SLOs using Bloom’s Taxonomy and the provided rubric. Case History

A 68 year old Caucasian woman presented to the ER on Friday evening after returning home

from helping in relief efforts after a hurricane. She was suffering from chest pains that came and went,

she was light headed, and stated that she had a pain in her left arm and back. The patient was also

having a slight shortness of breath. Her height was 5’2, and current weight was 160. Blood pressure

was slightly elevated at 168/90 and her respirations were 22 bpm. An EKG and cardiac panel were

ordered and the patient was administered a nitroglycerine tablet.

The phlebotomist arrived and verified all the required information with the test requisition and

patient bracelet. After the verification, the phlebotomist proceeded to collect the patient’s blood and

label the tube with the preprinted label that was included with the computer generated requisition

form. The phlebotomist then printed her tech code and date and time of specimen collection on the

label by hand and the sample was sent to the lab for testing.

The accessioner who received the sample verified that the date of collection, date of birth, and

patient’s last name matched the requisition but the first name and medical record number were slightly

different. The accessioner then called the ER and notified the department that a sample needed to be

recollected due to the discrepancies in the first name and medical record number of the specimen label

and requisition form.

Student Learning Outcomes

Discussion

Errors can and do occur occasionally with laboratory specimens. There are three types of errors

that can occur in the lab. These errors are commonly known as pre-analytical, analytical and post-

analytical errors. Pre-analytical errors are the most common errors that occur in the laboratory today.

These types of errors occur before the sample is tested. Some examples would be specimen

mislabeling, which could include missing tech codes on a sample, patient name misspellings, or

mismatched specimen and requisition, patient preparation, collection of sample in the wrong tube type

etc. Analytical errors are errors that affect analysis of the specimen during testing such as testing

review, lab interpretations, result accuracy etc. Post-analytical errors are errors that occur after the

testing has been completed. This type of error may include errors in calculations, resulting errors,

failure to report critical values to the correct person etc.

Patient safety and lab turnaround times are of top priority in hospitals and health care facilities

worldwide. Specimen labeling has a great impact on these aspects. In a study done by the College of

American Pathologists, it is estimated that more than 160,000 adverse events in the US per year are the

result of misidentification or mislabeling of patient specimens. [1] One of the top reasons for rejection of

a patient specimen is a mismatch of the specimen and requisition that is sent with that specimen. This

is considered a pre-analytical error that results in the rejection of the sample. A study that was

conducted to determine the most common reason for specimen rejection determined that pre-analytic 2