Patient Safety in the Laboratory

Developing Professionals Forum

Brittney Craig, MHS, ASCLS Developing Professionals Forum

The work delivered by laboratory professionals each day is heavily centered around patient safety. Laboratory professionals dedicate countless numbers of hours verifying, analyzing, and performing tests on each specimen received in the laboratory. They perform several tasks to ensure all patients always receive the most efficient and best quality of care. In the laboratory, safety checks begin with running extensive quality control tests and maintenance on all instrumentation. This ensures that all instrumentation is running efficiently, and the results received are the patient’s true results. The safety checks continue with the preanalytical phase and continue through the post-analytical phase of testing.

“Educating is one of the most important aspects that occurs to allow patient safety to remain a top priority.”

Once the sample arrives in the lab, the specimen is handled with care, and labels are checked thoroughly to ensure there aren’t any mislabels. Tests are verified to ensure the appropriate tests are being ordered and performed, and the integrity of the specimen is checked thoroughly to ensure it is acceptable for testing. Completing a thorough check of each specimen ensures the intended patient is receiving accurate results and will receive the treatment that is intended for their condition. One important aspect to note is if a mislabel has been identified, laboratory professionals take this opportunity to educate staff by completing an incident report form. With this form, involved staff members are educated on the corrective actions they should take to avoid certain types of mistakes. Reporting these errors allows the facility to identify learning opportunities and keep a record of the weaknesses that need to be rehabilitated. Having this in place helps prevent patient harm and keeps all staff members informed and up to date on current procedures carried throughout the facility.

Educating is one of the most important aspects that occurs to allow patient safety to remain a top priority. Laboratory professionals constantly participate in continuing education courses and read/form procedures that help build knowledge on the different instrumentation and all tests that are performed. With this knowledge, the laboratory professionals can critically think and solve all types of situations, and they are able to accurately interpret all results to other healthcare professionals who are part of each patient’s team. In turn, these results allow the healthcare team to make the best decisions for the patient’s treatment plan.

In the analytical phase of testing, the instrumentation has different safety checks incorporated into the software to ensure the integrity of the specimen is acceptable and is not interfering with the results. For instance, there are ranges for hemolysis, icterus, and lipemia incorporated in the chemistry and coagulation instruments. These ranges are used to detect when the integrity of the specimen may be interfering with the results. Having these safety nets in place can help assure that the results that are being given are accurate and have been verified thoroughly. Also, there are detectors incorporated in the instrumentation that can inform when there is a clot, a short sample, a barcode error, etc. With these flags in place, they can alert the laboratory professional when there is an issue so that the test would not be delayed. It is crucial that test results are not unnecessarily delayed as it could lead to serious harm or death for the patient.

In the post analytical phase of testing, laboratory professionals closely analyze all results to make sure the results are reported correctly, and the results correlate with the previous results, if available. If there is an incident where they don’t correlate, they will notify the appropriate persons caring for those individuals with the current notification values. Communicating when there is a concern, a critical value, or noticeable changes in their results is very important to maintaining patient safety. Keeping an open stream of communication among all individuals working with each patient is important, and it is a skill that laboratory professionals utilize every day. For example, when performing handoff at the conclusion of the shift and extensive testing is needed for a sample, it is necessary to communicate all information about the sample to the relief person, so that there will not be a delay with the test results. Delaying test results could lead to detrimental outcomes, so it’s important to always communicate and move efficiently.

Overall, laboratory professionals play a huge role in patient safety and making sure patients are receiving the care that is intended for their conditions. It is imperative that they make sure that all instrumentation is running appropriately to provide accurate results, to make sure the specimen is received for the intended persons and that the appropriate tests are being performed, to ensure the integrity of the specimen is checked thoroughly, to always communicate, and to ensure the results are accurately resulted. With laboratory professionals performing several checks and balances throughout the day this ensures that the patient will receive care that focuses on their safety first!

Brittney Craig is a Medical Technologist at WellStar Windy Hill Hospital in Marietta, Georgia.

Learn more about the Developing Professionals Forum for student members of ASCLS.