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Emergency Center
Surgical Services
ICU / Surgical Suites
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Emergency CenterSpecimen Quality
Extended TAT
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Mislabeled Specimens≥ 1 / month
Contaminated Blood Cultures
Improper collection technique
Delayed specimen transportation
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Sample-related specimen rejection
Accounts for 46% of specimen rejections
Improper specimen labeling
Not labeled at the time of collection in the presence of the patient
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Advanced PCT TrainingProvided by Laboratory
Initial Training:8 hours for PCT
4 hours for Nurse
< 80 hours over 2-3 pay periods
Continuous ReinforcementPeriodic education at staff meetings as needed
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Improved Labeling Lab collection labels
Admission labelsPrint two sheets automatically when registered
Print manually
HandwrittenBlank labels / Sharpie
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Tube SystemTransportation of specimens as collected rather than in batches
Transportation of “add-on” lab requisitions
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Improved specimen qualityImproved specimen rejection ratesDecreased contamination ratesImproved interdepartmental teamwork
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Time from order to receiptTime from collection to receiptResponse time for laboratory collections
Blood CulturesBlood Bank
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Centralized slot boardOrganization of collection labels
Organization of reports
Visual organization of workflow
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Laboratory AssistancePhlebotomy area in third Triage
Staffed from 1pm – 9pm Monday thru FridayAssistance with Blood Bank and Blood CulturesAssistance with EKG’s
Note: Promed “blue screen” required for Triage order entry
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Blood Culture TeamworkEC staff draws 1st set with initial blood work
No line/I.V. draws (unless specified by physician)
Training provided by lab
Laboratory draws 2nd set
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Improved TATSpecimen collection
Lab reports
Improved Blood Culture process
TAT for 1st set
TAT for initial blood work
Core measures Less delay in starting antibiotics
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Surgical ServicesPre-operative process
Blood Bank armbands
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Blood Bank armband (from pre-admission testing) required
Delay in Blood Bank response time
Distance (increased)Staff unavailable or involved in critical case
Delay in surgery schedule
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Transportation of Blood Bank armband thru tube systemPatient armband applied by outpatient lab personnel
Patient identifiers cross-checked
Includes Blood Bank ID card presented by patient
Training provided by Blood Bank
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Less delays in pre-operative processImproved time management for Blood Bank personnelImproved interdepartmental teamwork
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ICU / Surgical SuitesNurse Collections (Line Draws)
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Poor staff utilizationRequirement for lab personnel to be present
Generally unnecessary
Slower laboratory critical response time
Requires increased laboratory staffing
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Independent Nurse Collections
Admission labels or lab labels for specimensNo line draws on blood cultures without physician orderReference material provided for appropriate sample type, volume, etc.Samples transported to lab thru the tube system
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Improved TAT for ICU reports
Improved medical staff satisfaction
Improved time management for laboratory personnel
Improved interdepartmental teamwork
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Misty Prock, M.T. (ASCP) - Presenter
Amy Pickelsimer, M.T. (AMT)
Jerry Falls, M.T. (ASCP)
Sandi Butcher, M.T. (ASCP)
Betty Hudson, M.T. (ASCP)
Penni Miller, M.T. (ASCP)
Pam Barber, ASPT