The newly revised venipuncture standard released by the Clinical and Laboratory Standards Institute in April, 2017 is the most comprehensive revision in the document's history. With over 140 new mandates, facilities have a lot of changes to implement. This series discusses one or more substantive changes each month.

As of last April, managers who have not updated their procedure for identifying patients are likely operating beneath the standard of care. Because patient identification continues to plague healthcare, especially when blood samples are drawn, the new standard beefs up the requirements and significantly changes the patient identification protocol every facility must employ to be current with the industry standard.

It the past, patients had to verbalize their full name, birth date, address, and/or unique identifier. The new standard requires patients to state their full name and birth date, and spell their first and last names.¹ For patients who are unable to speak or for whom there is a language barrier or cognitive impairment, a caregiver or family member must provide the information. The information provided must then be compared with the ID band and the orders, requisition, or labels for the sample. The ID band must be attached to the patient. If attached to the bed, placed on a nightstand, or anywhere else than on the patient, it cannot be considered as a valid ID band.

For outpatients without ID bands, an identification card or some other form of ID must be provided, and the same comparisons made with the orders. Studies have found up to 16 percent of ID bands are missing or contain erroneous information.^2,3  

Asking the patient to state his/her full name and birth date rather than affirming information the collector verbalizes is critical. If the collector were to state the name and birth date and seek the patient's affirmation, the patient may affirm a name that was not properly understood just to be polite and accommodating. 

References

1. CLSI. Collection of Diagnostic Venous Blood Specimens---Approved Standard, GP41-A7. Clinical and Laboratory Standards Institute, Wayne, Pennsylvania. 2017.
2. Howanitz P, Renner S, Walsh M. Continuous wristband monitoring over 2 years decreases identification errors: a College of American Pathologists Q-Tracks study. Arch Pathol Lab Med 2002.
3. Paxton, A. Stamping out specimen collection errors. CAP Today. May, 1999.

Editor's note: Readers are urged to obtain their own copy of the standard as soon as possible and begin implementing all new provisions as soon as possible. The document, Collection of Diagnostic Venous Blood Specimens (GP41-A7), is the standard to which all facilities will be held if a patient is injured during the procedure or suffers from the consequences of an improperly performed venipuncture.

Read an interview by CLP Magazine with Dennis J. Ernst MT(ASCP), NCPT(NCCT) about the revised standard.