Basic guidelines for specimen labeling and handling are provided below. OSF HealthCare Saint Francis Medical Center Laboratory requires that two unique patient-specific identifiers be documented on the specimen container in order to verify patient identity; at a minimum, patient's full legal first and last name and date of birth (DOB) are required.  Please refer to the Specimen Labeling Memo for complete instructions and Joint Commission labeling guidelines.

• Affix the label directly under the cap of the tube, over the manufacturer’s label, with the name side of the label oriented upwards.  Leave a visible window on the side of the tube so the contents can be seen.
• For safe handling of specimens, biohazard bags with two pockets are provided. Specimens should be placed in the zip-locked pocket along with any extra labels, and the requisition put in the outside pocket. One bag should be used for each patient.  Place all the small bags in a large specimen bag.  Epic users, include the packing list in the outside pocket of the large bag.
• For specimen containers with lids, the label must  be placed on the container itself, NOT the lid.  Lids are removed from containers and patient identification is compromised if the lid contains the label.
• Upon receipt in the laboratory, the patient's full first and last name and DOB are verified by comparing the label on the specimen container to the accompanying order, historical records, and our electronic medical record (patient names must match letter for letter).
• When a discrepancy is identified, the laboratory will contact the submitting facility to obtain clarifying information to assure that the testing is being resulted for the correct patient.  In some cases, additional information such as a government issued ID, additional documentation, or a patient information sheet may be required to support any amendment to patient demographics. 

The OSF HealthCare Saint Francis Medical Center Laboratory will accept alternate unique identifiers in place of a discrepant name or DOB; alternate identifiers must be present on the specimen label at the time receipt.  Unique identifiers may include, but are not limited to, client's medical record number, client's order or accession number, or social security number.

• Be sure all specimens are segregated, as to frozen, refrigerated or room temperature.

Consult the OSF Directory of Services or the Epic Procedure Catalog for stability and transport questions and for proper tube color requirements.

Specimen Submission Guidelines

Our laboratory has noticed an increase in the number of specimens that are submitted to our laboratory that are mislabeled, lacking patient identifiers, and/or unlabeled.

Our goal is to adhere to Joint Commission (JC) and the requirements set forth in the #1 Hospital National Patient Safety Goal (NPSG.01.01.01): Identify Patients Correctly.

This standard requires two unique patient identifiers and JC further specifies that the two identifiers be on both the requisition/order AND the specimen label.

As part of our OSF quality culture and mission, we are dedicated to following these regulations in order to ensure the highest level of safety for the patients we jointly serve.

GUIDELINES THAT MUST BE FOLLOWED WHEN SUBMITTING LAB SPECIMENS TO OSF HEALTHCARE LABORATORY

• Specimen label must contain the required two, unique identifiers. The two identifiers on the label must match the corresponding identifiers on the order/requisition.
• Label the specimen in the presence of the patient along with patient (whenever patient is capable), jointly verifying accuracy of the patient identification information.
• Surgical pathology specimens must be labeled and requisitions prepared in the room where the surgical procedure is performed.
• OSF requires two identifiers:  The patient name (full first and last) and patient date of birth (DOB).

Unless the specimen is deemed irretrievable by one of our pathologists/lab leadership staff, specimens lacking the two accurate identifiers on the label must be rejected.

*Irretrievable specimens are specimens that are extremely difficult or impossible to recollect due to the nature of the specimen or due to unique circumstances under which the specimen was obtained. These types of specimens are usually body fluids obtained via invasive procedures, bone, bone marrow, CSF, non-gynecological specimens obtained via invasive procedures, post-mortem specimens, synovial fluid, tissue (pathology), and cord blood. Samples such as clinical blood samples, urine, swabs, and PAP samples, are not irretrievable in nature and specimen rejection due to labeling errors must occur in order to be compliant regulations and patient safety goals.

Specimen Labeling - Best Practices

• Whenever possible, use computer generated labels.
• If a hand-written label is absolutely necessary, in addition to patient ID verification at the time of the draw, strongly consider having a second verification, performed by staff, of hand-written information.
• Ensure proper placement of label on collection container. For example, for pathology specimens, do not place the label on caps/lids, as the lid is not permanently attached to the collection container and there is risk of losing the label.
• If a surgical/pathology specimen requires documentation of collection site and/or source, carefully ensure that the specimen identifying information on collection container matches exactly with the specimen information on the order or requisition.

Please know that we must adhere to these specimen rejection guidelines in order to fully ensure patient safety.

As you may know, most laboratory errors are not analytic in nature but rather pre-analytic and often linked back to specimen labeling issues.

Your assistance in ensuring the best patient care and adherence to regulatory standards is highly appreciated.

It is always difficult to reject a specimen, yet if best labeling practices are followed, these situations should be very limited.