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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 | 14:40 | 14:45 |
| 20:00 | 19:40 | 19:45 |
*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:
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.
When the LLT reports to the unit, he/she will check the LLT clipboard for any stamped requisitions or labels 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.
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
Check the LLT clipboard on your unit for delays or cancellations. Blood draw status is indicated on the Nursing Collection Checklist (NCC).
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.
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:
Pre-op admissions can be drawn stat until 7:30 AM. Pre-op heart or lung transplants can be drawn stat anytime. 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
Order the tests in EPIC or complete a
requisition and place the labels or the completed requisition on the LLT
clipboard. 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. 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:
- 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.” nel.”
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 |
- 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
-
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. Collect tubes in the proper order:
Blood cultures
Non-additive tubes ( red, SST (gel tube), plain navy)
Coagulation tubes (light blue)
Additive tubes (green, lavender,pink, gray, navy - either with heparin or EDTA))
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.
Label all specimens at the bedside.
Barcode label placment: CBC - tubes top off the tube. Light blue tubes - bottom of the tube. For all other tubes, place the label in the middle of the tube.
Use label sets only for the day indicated. Return label set to the laboratory with the specimens.
If you have any questions about what to draw, please page the LLT supervisor at 85-7090.
Unused label sets should be returned to the laboratory at the end of the day with "CANCEL" written on them.
RESEARCH STUDIES ON INPATIENTS
The LLT will draw inpatient research study specimens under the following conditions only.
A research study requisition with a client
number may be placed on the LLT clipboard before the beginning of a
sweep.
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).
Revision date: May 2007
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