Volume 37 Number 6 | December 2023
Victoria Roop, MLS(ASCP)CM, ASCLS Today Volunteer Contributor
Phlebotomy handheld solutions (PHH) is an on-the-go technology that allows laboratory phlebotomists the ability to properly identify a patient, print labels at bedside, and provide a real-time list of specimens needing collection. Patient safety is always a number one concern within the laboratory. Errors can occur at every intersection of pre-analytical, analytical, and post-analytical care. PHH technology focuses improvements on the pre-analytical care of a patient. This newer technology gives both the patient and laboratorians a higher level of confidence that the correct patient has been identified, current orders are up-to-date, and the correct samples were drawn.
Proper Patient Identification
Proper patient identification has been drilled into our heads since school. Every competency in every department has laboratorians rehearsing that the patient’s full name, date of birth, and/or medical record number are the accurate forms of identification before going any further. Common errors seen in the laboratory are patients with identical names but different dates of birth (i.e., Will Smith 3/13/1949 and Will Smith 4/15/1978); twins with similar first names (i.e., Oliver and Olivia) who share the exact last names and date of births; or patients who share the same name and birth dates, but the decades are off (i.e., Jane Doe 1/12/1919 and Jane Doe 1/12/2019). These errors, along with countless others, have occurred, which causes downstream errors resulting in wrong lab results on a patient, causing inappropriate care, and consequently resulting in possible harm to the patient and even death.
Phlebotomy handheld solutions (MEDITECH)1 prevents errors like these before they even happen. It sets the laboratorian up with relevant patient data in the patient’s room with “customizable, intuitive workflows1” based on what each team needs. Door County Medical Center, where I currently work as a medical laboratory scientist, is in the process of implementing these in our work processes. By the end of 2023, our laboratory will be able to walk into a patient’s room and scan the patient’s hospital identification band with the PHH to verify a patient’s identification, along with verbal and/or care giver’s confirmation. The handheld device will not allow a laboratorian to advance to the next screen unless the correct patient identification is scanned.
“Laboratorians have a sense of power and confidence in their work, knowing they are in the place they need to be, providing a service to our patients and providers to get answers they need for the correct diagnosis and the correct care.”
Current Laboratory Orders
I do not know how many times I walked into a patient’s room with specimen labels that printed off from a provider requesting a draw, had drawn the patient, and then walked back down to the laboratory to receive the sample I just collected to find out the provider cancelled the order mere minutes after I was deployed for the phlebotomy. Not only did I perform a phlebotomy on a patient unnecessarily, but I wasted time and resources that could have been utilized elsewhere. The PHH solutions will be able to cut down on the waste and cost of unnecessary draws and laboratory labor hours.
In our laboratory, we are replacing the auto printing of labels at the time orders are placed with a laboratory information system (LIS) tracking screen to know if and when a draw is to take place. When the laboratorian enters a patient’s room to scan the patient’s armband for patient identification, they will again know if the orders seen on the tracking board are still current. If at any time a provider cancels the lab order, it will no longer be seen on the PHH or the tracking screen instantaneously.
Correct Sample Types
There are times when laboratory staff do not have all of the lab order labels with them, or do not have any information at all because they got a call telling them to go into another patient’s room. When they ask what to draw, they get the usual response, “Just draw a rainbow” (a.k.a., light blue sodium citrate tube, serum separator gold top tube, green lithium heparin plasma tube, and ethylenediaminetetraacetic acid (EDTA) tube). So, the laboratorian draws those tubes and returns to the lab. They find the labels that match the patient information written on the tubes only to discover there was also a lactate order, which requires a different tube additive from what they already drew. This means, the laboratorian now has to return to draw the patient for a second time. Again, this wastes valuable time, labor, and resources, not to mention the loss of patient satisfaction.
The PHH solution systems allows each user a handheld device they carry with them while deployed outside the laboratory that will let each user know in real-time who has lab orders and what sample types are required for each one. Moreover, the PHH has customizable options, such as order of draw,2 based on the facility’s established sample types built into its LIS systems.
Mobility is the wave of the future. It means being able to do more with less, while simultaneously putting the needs of the patient at the forefront. By utilizing these phlebotomy handheld devices within the laboratory, it increases communication among staff (i.e., emergency areas, post-surgical units, intensive care units, OBGYN, etc.), efficiency, employee satisfaction, and patient safety3. These tiny devices that fit in the palm of our hands hold the most impact on our patients. We are provided with the right information, at the right time and location. There are no guessing games or things being missed due to a breakdown in communication. Laboratorians have a sense of power and confidence in their work, knowing they are in the place they need to be, providing a service to our patients and providers to get answers they need for the correct diagnosis and the correct care.
- Expanse: The Power of Mobility. (n.d.). www.youtube.com. Retrieved September 10, 2023, from https://www.youtube.com/watch?v=nrzC1Teszjs
- Kipper J Marketing. (2019, January 16). Order of draw. Express Lab. https://www.expresslabidaho.com/collectiontips/order-of-draw-3/
- Gienna Shaw (2023, May 22). Mobile computers for healthcare: How they benefit patients and staff. Technology Solutions That Drive Healthcare. https://healthtechmagazine.net/article/2019/09/mobile-computers-healthcare-how-they-benefit-patients-and-staff
Victoria Roop is Blood Bank Lead Technologist at Door County Medical Center in Sturgeon Bay, Wisconsin.