Survey Says: Tube labeling practices

Last month we wanted to know what your tube labeling practices are. It seems to have been an issue you've been wanting to talk about, since it was one of our biggest survey ever in terms of participants. 

First we asked if you ever labeled tubes you didn't draw. Sixty percent said they never do, but 36 percent admitted they will label tubes they don't draw only if they witness the collection including the patient identification step. 

Next, we wanted to know, of the tubes you draw yourself, do you ever label them away from the patient. A full 81 percent said they never label away from the patient, but 18 percent said they sometimes do. One person said they never label in the presence of the patient. 

Then we asked if you ever label tubes before they are filled. and if you think it's an acceptable practice. Seventy-nine percent of you said you never pre-label tubes, while seven percent said you do because it's acceptable where you work. Fourteen percent said they don't even though it's acceptable at their facilities. It's important to note pre-labeling tubes goes against the CLSI standards.

Regardless of the policy at their facilities, almost 90 percent said pre-labeling should not be acceptable. Here are some of your comments:

• What if you miss a tube and someone else uses it in error?
• A patient died in my home city because of this a few years ago. Never ever prelabel tubes.
• We used to pre label tubes but we found that there were too many errors and we also found staff discharged patients too quickly. Apart from the safety of labelling the tubes afterwards, it requires longer post-venepuncture care and the wound care is improved as a bonus.
• There are times I think it may be acceptable to label tubes prior to collecting as long as the patient is able to verify the labels on the tubes.
• If the tube is prelabeled and no blood is collected then another label has to be reprinted in order to put it on the tube that was collected on the second attempt.
• Yes, but only for isolation patients as it is infection control policy. I have never been comfortable with it and I protested against it when the new infection control policy was brought in.
• It's NEVER acceptable!
• I also have the patient/parent spell first & last name, state birthday precollection, and everyone in the room old enough to read (patient/family/nurses) check the tube labels post collection.
• Yes, but the labeled tubes are matched against the ID band before leaving or dismissing the patient.
• Saw someone get fired for this my first year on the job and have NEVER done this.
• Although I know it's not good practice, when bleeding in the outpatient area and I'm collection 5+ tubes, I will label the first few, check and release the patient, then label the rest at the same station. Mainly this is because we hand-write on our tubes and this makes a long time for patients to be waiting, and they tend to get disgruntled. I never move from where I have been working however. In the wards though I never label away from patient and have even made doctors and nurses wait while I label at bedside.
• Some patients just up and walk away while I'm labeling tubes.
• If they leave the draw station before I'm done then yes but I don't start something else or leave the impatient room
• At the medical group where I work, at times patients have had 12 or more tubes drawn in one sitting. I have started the labeling process in front of them, but they are too antsy and leave.
• I have them put pressure on the site while I label the tubes. Then I know pressure was put on it for an adequate amount of time.
  
  

This month, we're asking what strategies do you use to reduce the pain of pediatric phlebotomy and calm the fears of pediatric and adult patients. Take the survey.