How is a phlebotomist positively identified, so that a transfusion service knows who collected a sample for pre-transfusion compatibility testing?

A transfusion service Quality Assurance Coordinator at a medical center in Virginia reports that patient samples for pre-transfusion compatibility testing are collected at her hospital by nursing and medical staff. Sometimes when following up on a specimen mislabeling error, the initials of the person who drew the sample are illegible or are not readily identified by the nurse in charge so that the name of the phlebotomist has to be investigated. Sometimes the samples are drawn by medical residents who are rotating through the department, and their initials are not always on file. For example, one recent mislabeled specimen was drawn by an anesthesiology resident, and it took nearly a week to figure out that the resident drew the sample in question. The QA coordinator would like her hospital to adopt a requirement that the phlebotomist's full name be written (i.e., hand-printed) on the sample tube, but she does not have the authority or the leverage to make this happen. She wonders what other facilities do to address this problem?

The following comments have been received.

ADDENDA May 7, 2006

1. A Technical Services Director at a blood collection center in Alaska reports that she has seen facilities utilize a unique employee ID number, that must be used to 'sign' all documentation. She assumes that such an employee ID number could be tracked back to an individual employee, if that employee were to serve as a phlebotomist.

ADDENDA May 17, 2006

2. A blood banker in Texas reports that identifying the phlebotomist of a pretransfusion blood sample has been a problem for years at her hospital until they implemented a system where employees of the facility are required to sign on to the computer with a 'mnemonic', such as LAB.LH, NUR.DW2 or SURG.JS5, that is unique to each person. When a phlebotomist draws a sample, they must use their mnemonic on the signature spot. They have reportedly had good compliance with this approach and the phlebotomist never has to print more than 7 letters. Their remaining problem is that nurse anesthetists are not registered in their computer, because they are a contracted group. However, the nurse anesthetists have agreed to print their names on the specimen tube labels.

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