Standard for Specimen Collection - BTS

Quality Lab Results Begin with Specimen Collection

Proper specimen labeling helps assure that the results are reported in a timely manner for the correct patient.

How to Label A Blood Specimen

  • Prepare a Label (Full legal name, Medical Record Number (MRN), Provincial Health Card Number (HCN)
  • Obtain the aid of a witness
  • Go to the bedside of the patient
  • Identify the patient
  • Match the label and the patient ID band
  • Collect the specimen
  • Label before leaving the patient
  • Place label as shown in pictures below
  • Initial and date the specimen

The Blood Transfusion Service Requisition must contain the following information or specimens will not be accepted:

  • Patient's full name
  • Patient's hospital medical record number (MRN) and/or provincial Health Card Number (HCN)
  • Signature of the person collecting the blood sample
  • Signature of the person witnessing the blood sample collection

The following additional information should be included on the requisition:

  • Date of collection
  • Test required
  • Blood componet and /or product needed an amount
  • Where the component will be used - OR, dialysis, patient's ward
  • Date and time blood components are required for transfusion
  • Specific clinical indication for the transfusion and/or description of elective procedure
  • Current hospital location of the patient

The QE II Blood Collection Service phlebotomy team is available to collect routine BTS specimens and additional samples required for resolution of serological problems. Specimens are collected on routine collection rounds. The unit personnel should collect specimens for urgent requests for blood components and investigation of a possible transfusion reaction.

Blood samples may be transported directly to the Central Specimen Accessioning area at the Halifax Infirmary (Level 600 Room 6509) or hand delivered directly to the BTS at the VG site (Centennial Room 094).

Inadequate or incorrect identification of patients is a common cause of serious complications associated with blood transfusion. It is impossible to over-emphasize the importance of proper patient identification.

  • When a specimen is collected for pre-transfusion compatibility testing, all patients including outpatients and those patients receiving off-site care, must have an identification wristband attached before the specimen is collected. The patient should be instructed not to remove the band until after the transfusion is completed.
  • Ask the patient to state and spell his or her name each time a blood specimen is collected.
  • Confirm the patient's full name and medical record number using the identification wristband.
  • Label the blood specimen tubes with the patient's full name and registration number before leaving the patient. The labels may be hand written, computer generated or printed by addressograph plates. The blood specimen labels must correspond with the identifying information on the patient's wrist band and on the BTS Requisition.
  • Initial and date the labels of all blood specimen tubes and sign the requisition form. The initials on the specimen tube and the "collected by" signature on the requisition identify the person responsible for the accuracy of the patient blood sample identification.
  • Ensure your witness initials the blood specimen tubes and signs the requisition form. The initials on the specimen tube and the "witnessed by" signature on the requisition identify the person responsible for the double checking the accuracy of the patient blood sample identification.
  • Blood specimens will not be accepted in the Blood Bank if there is any doubt about the accuracy of patient identification. Unlabeled or misidentified specimens will be discarded and a freshly drawn and appropriately labeled specimen must be collected.

If the patient's identity is unknown initially, a new medical record number could be assigned to the patient. The designation "XX YY" will be used as the name identifying the patient. This identification is used to label blood samples and requisitions.

The wristband with the "XX YY" designation shall not be removed during the hospital stay. Once the patient has been identified the patient's name will be updated in the PCIS and LIS. The patient may have a previously assigned MRN and a second armband with that MRN will be placed on the patient.

Blood crossmatched and labeled for Unknown Patient will be transfused with that MRN even after the patient's true identity has been discovered until the BTS has received and tested a new specimen with the updated MRN. Therefore the "Unknown" wristband remains on the patient. If the "Unknown" wristband is removed, a new blood sample with the patient's correct name and MRN that matches the patient's current wristband is required to provide blood components for transfusion.

Volume to be collected

  • A full 6mL EDTA specimen (lavender top) is sufficient to perform a Type and Screen.
  • A larger number of blood specimens may be required when antibody identification studies are indicated. A physician on the patient's service will be notified if an antibody problem is encountered and if additional specimens are required.

Additional specimen collection information

  • Blood specimens collected in serum separator ("Corvac" or "SST") tubes are unacceptable.
  • Blood specimens must not be obtained from the tubing of an intravenous infusion set or drawn from a vein in which an intravenous solution is flowing.
  • Drugs and intravenous solutions can alter serologic reactions (e.g. dextran may cause rouleaux and false positive reactions and dilute specimens so that incompatibilities cannot be detected). If blood specimens are collected from an anti-coagulated catheter a 1mL sample should be collected and discarded before the collection of the BTS blood sample.