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GENERAL GUIDELINES FOR BLOOD COLLECTION
INPATIENT BLOOD DRAWING GUIDE

Blood Collection - Routine Sweeps

Sweep Time Order Cutoff Time * Label Print Time
06:00 04:40 04:45
10:00 09:40 09:45
15:00 14:4014:45
20:00 19:4019:45

*Order cutoff time is defined as the latest time orders may be placed in EPIC.

When EPIC is unavailable, a requisition should be completed and left on the Laboratory Liaison Technician (LLT) clipboard for drawing at the next scheduled sweep time.
 

WHAT TO DO IF YOU MISS THE ORDER CUTOFF TIME FOR THE NEXT SWEEP

From the time the labels print in the lab until the LLT arrives on the unit:

  1. Place a timed order in EPIC. If the requested time is before the next label print time, the label will print on the unit. Place the label on the LLT clipboard. If EPIC is unavailable, complete a requisition.

  2. When the LLT reports to the unit, he/she will check the LLT clipboard for any requisitions or label sets for tests ordered as above. These will be drawn during that current sweep. The LLT will not check the clipboard again during that sweep. The greeting sheet indicates when the LLT has checked the clipboard for that sweep. Once the LLT has started the sweep on the unit, the LLT will only accept requisitions for add-ons to patients that are currently scheduled to be drawn and have not yet been drawn during the current sweep.

  3. Nurse draws that are unsuccessful may be left for the LLT to draw during the next sweep.
     

WHAT TO DO IF YOU HAVE QUESTIONS ABOUT THE BLOOD DRAW STATUS OF A PATIENT ON YOUR UNIT

  1. Check the LLT clipboard on your unit for delays or cancellations. Blood draw status is indicated on the Nursing Collection Checklist (NCC).

  2. Contact the LLT assigned to your unit. The name and the pager number of the LLT are indicated on the greeting sheet on the LLT clipboard.

  3. If there is still a question, page the LLT Supervisor at 85-7090.
     

BLOOD COLLECTION - STAT DRAWS BY THE LLT

Stat blood draws are performed between 10:30 PM and 5:00 AM MONDAY THROUGH FRIDAY ONLY (not including holidays) with the following exceptions:

  1. Pre-op admissions can be drawn stat until 7:30 AM.

  2. Pre-op heart or lung transplants can be drawn stat anytime.

  3. Page the LLT Supervisor at 85-7090 to request the LLT. Tell the supervisor the patient's name and location. Order the tests in EPIC or complete a requisition and place the labels or the completed requisition on the LLT clipboard. The LLT will report to the unit, retrieve the labels or requisition from the clipboard and draw the stat.
     

TO REQUEST A STAT BLOOD DRAW BETWEEN 10:30 PM AND 5:00 AM MONDAY THROUGH FRIDAY

  1. Order the tests in EPIC or complete a requisition and place the labels or the completed requisition on the LLT clipboard.

  2. Call extension 25002 and tell the lab that there is a stat to be drawn, giving the patient's name and location. Stat requests must be called to extension 25002 and not merely left on the clipboard.

  3. The LLT will report to the unit, retrieve the labels or requisition from the clipboard and draw the stat.
     

BLOOD COLLECTION - SPECIAL TESTS

1) DRUG DRAWS - Timed Pre and/or Post Amikacin, Gentamicin, Tobramycin or Vancomycin draws. When ordering for a future sweep on the same day, use the sweep time previous to the expected time of the collection. For draws for the next day, order for 06:00 draw and the LLT will consult with the nurse about the exact time of draw. (A 06:00 Label may be used up to the 20:00 sweep.)

2) PRESCHEDULED TIMED TROPONINS AND APTT - Blood draw and label print location depends on the time the order is placed and whether or not the patient has a central line. Please see below for examples:

  1. Patient without central line (LLT Draw)
     
    Time of Draw Order must be
    in computer by
    Label Print Time
    in Lab
    06:00-09:59 04:40 04:45
    10:00-14:59 09:40 09:45
    15:00-19:59 14:40 14:45
    20:00-05:59 (next day) 19:40 19:45

    If the requested draw time(s) are before the next cut-off time for LLT draw, the labels(s) will immediately print on the nursing unit, which is responsible for collecting these specimen(s). The label can be left on the clipboard if it is before the start of the next sweep.

    Because of the long time between LLT sweeps on nights, the following accommodation has been made. If timed orders are placed for collection from 7:30 PM until 5:30 AM, this message will appear:

    “You have placed a PTT timed order or a Troponin timed order due for collection between the hours of 7:30 PM and 5:30 AM. Place label on LLT clipboard and call extension 25002 to notify the LLT supervisor. Samples to be drawn in less than 2 hours are to be collected by unit personnel.”

    EXAMPLE #1:
    Draw times of 11:00 and 17:00 are requested at 8:00
    Time of Draw Label Print Time Print Location Collection by
    11:00 09:45 Lab LLT
    17:00 14:45 Lab LLT

    EXAMPLE #2:
    Draw times of 11:00 and 17:00 are requested at 10:10
    Time of Draw Label Print Time Print Location Collection by
    11:00 10:10 (Immediately) Unit Unit Personnel/LLT*
    17:00 14:45 Lab LLT

    * When the LLT reports to the units, he/she will check the LLT clipboard for labels. The LLT will not check the clipboard again during the sweep. The greeting sheet indicated when the LLT has checked the clipboard. Once the LLT has started the sweep, the LLT will only accept labels for add-ons to patients that are currently scheduled to be draw and have not yet been draw during the sweep.

    EXAMPLE #3:
    Draw times of 2:00 and 08:00 are requested at 21:00.
    Time of Draw Label Print Time Print Location Collection by
    02:00 21:00 (Immediately) Unit LLT (Call Lab @ 25002)
    08:00 04:45 Lab LLT

    EXAMPLE #4:
    Draw times of 2:00 and 08:00 are requested at 01:00 (outside the 2 hour window)
    Time of Draw Label Print Time Print Location Collection by
    02:00 01:10 (Immediately) Unit Unit Personnel
    08:00 04:45 Lab LLT

     
  2. Patient with central line (Routine Nurse Draw)

    Time of Draw Order must be
    in computer by
    Label Print Time
    in Lab
    02:00-09:59 23:55 00:01
    02:00-09:59 01:40 01:45
    10:00-14:49 09:40 09:45
    15:00-19:59 14:40 14:45
    20:00-01:59
    (next day)
    19:40 19:45

    ** 8 and 10 Kellogg labels print at midnight per their request

    Labels for nurse draw are printed in the lab and tubed to the unit in green envelopes.

    EXAMPLE #1:
    Draw times of 11:00 and 17:00 are requested at 8:00
    Time of Draw Label Print Time Print Location Collection by
    11:00 09:45 Lab Unit Personnel
    17:00 14:45 Lab Unit Personnel

    EXAMPLE #2:
    Draw times of 11:00 and 17:00 are requested at 10:10
    Time of Draw Label Print Time Print Location Collection by
    02:00 01:10
    (Immediately)
    Unit Unit Personnel
    08:00 04:45 Lab LLT

 

NON-LLT DRAW SPECIMENS  

  1. Prescheduled nurse draw labels will print in the lab at 00:01 (8 and 10 Kellogg only), 01:45, 09:45, 14:45 and 19:45 and will be tubed immediately to the unit.

  2. Collect tubes in the proper order:

    1. Blood cultures

    2. Non-additive tubes ( red, SST (gel tube), plain navy)

    3. Coagulation tubes (light blue)

    4. Additive tubes (green, lavender,pink, gray, navy - either with heparin or EDTA))

  3. Mix additive tubes (including SST, and coagulation tubes) immediately by gently inverting each tube as it is collected. It takes 5-10 repetitions to completely mix the additive. Avoid vigorous mixing. This causes hemolysis.

  4. Specimen Labeling

    1. Label all specimens at the bedside

    2. Placement - Vacutainer tubes:

      All labels should be placed lengthwise on the tube in such a manner to leave an opening or "window" to view the specimen contents for suficient quantity, hemolysis etc. For CBC tubes - the label is placed toward the top (stopper) of the tube. Light blue tubes - toward the bottom of the tube. For all other tubes, place the label in the middle of the tube.

    3. Placement - Microtainers

      The small label sticker should be placed on the microtainer tube. The larger sample sticker should remain on the label set.

      In both cases the label set should be sent along with the sample. The label set should include the time of collection and initials or LLT number of the person who collected the sample.

  5. Specimen Identification

    The actual sample collected must be labeled with a minimum of patient name and medical record number. If using a lab generated label all the necessary info is included. If sending a specimen with a paper requisition you must label the actual sample with an EPIC patient sticker or hand write the patient's name and medical record number. Collection time and other information such as doctor's name and pager, patient location and source of sample must be noted on the requisition.

  6. Use label sets only for the day indicated. Return label set to the laboratory with the specimens.

  7. If you have any questions about what to draw, please page the LLT supervisor at 85-7090.

  8. Unused label sets should be returned to the laboratory at the end of the day with "CANCEL" written on them.

  9. If a patient is designated as a nurse draw, the phlebotomist will not draw the patient on the first sweep of the day. Before the second sweep the phlebotomist will check their pending draw list, if it is found that the nurse did not draw the patient by the time of the second sweep, the phlebotomist will investigate and if necessary, draw the patient.

 

RESEARCH STUDIES ON INPATIENTS

The LLT will draw inpatient research study specimens under the following conditions only.

  1. A research study requisition with a client number may be placed on the LLT clipboard before the beginning of a sweep.

  2. A research study requisition with a client number may be given to the LLT during the sweep as an add-on, and the LLT will draw it if he/she has orders to draw the patient and has not yet to do so.
     

SAMPLE REQUIREMENTS

Test requirements can be located through the Rush Intranet, Clinical Resources, Rush Medical Laboratories User's Guide or www.rush.edu/rml. If the test is not listed, please contact our Client Services Department at extension 22378 (2-BEST).
 

LABORATORY INFORMATION

For lab results, test or billing information, add-ons or reports, please contact our Client Services Department at extension 22378 (2-BEST).

For billing and pricing, call Financial Counselors at extensions 25644 or 28852

For research pricing, call LIS at 22314




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