Inpatient Phlebotomy Services
Inpatient Phlebotomy is a 24/7 service for all adult and pediatric non-intensive care units. Blood-only specimens are collected. All routine and PRN draws orders are made via the Hospital Epic Order Entry. Lab test names, along with synonyms and complete test information, can be found in the Test Directory. All orders must be placed into the Epic order entry system prior to Phlebotomy arrival to unit. If the label
has been printed, refusal of Phlebotomy collection by the patient or provider
will result in cancellation of the order and nursing notified. In the case where the patient is unavailable,
one reasonable attempt to return to a patient will be made unless that
non-availability is expected to be more than a few minutes. Cancellation of orders will occur when the
patient is missed by 2 phlebotomists twice (missed X2), patient unavailable X2,
patient expired, patient refusal, provider cancellation, or patient expired. Phlebotomy can use RN/provider printed labels
when a collection has been unsuccessful. Phlebotomy cannot initiate an "Add On"
order to an already collected specimen, whether in the lab or in hand. This is completed by provider staff using the
"Add On' icon in Epic from the received specimen in the Cornelia.
Routine Phlebotomy Orders
All routine orders are ordered in Epic with a Lab Collect order class. Routine collections are scheduled for two hour draw windows during the following draw times: 0500, 0800, 1000, 1200, 1400, 1600, 1800, 2000, 2200, 0000 and 0200. The 0500 (morning draw) is collected by a team of phlebotomists who are assigned to specific floor locations. Units are prioritized according to the patient population needs and the windows of specific newborn, TDM, and transplant tests. The morning team does not collect multi-sequential timed tests (2 hour GTT's, Cortisol Stim Tests, etc). Inpatient phlebotomists carry Hand Held "Rover" devices and label printers for accessioning of Lab Collect Orders at the patient bedside. Access to unit workstations and printers is required during downtime procedures.
Collect Now and PRN Phlebotomy Orders
Collect Now, PRN, and Routine, Once orders are collected 24/7 by inpatient phlebotomy by calling Vocera to "Float Phlebotomy". Draws will be collected by Vocera called in order or prioritized
by patient need, as communicated by patient RN to Phlebotomy. Collect
Now Unit Collect orders must be "toggled" in Epic to Lab collect before
phlebotomy float is called. Failure to toggle order to Lab Collect will
result in delay of collection. Orders that cannot wait until the next collection list time can be ordered for Routine, Once. If collection is needed immediately, the RN can Vocera "Float Phlebotomy" to inquire if available; and if not, the RN must collect specimen(s).
A bar coded OHSU ID bracelet with the patient's MRN, correctly spelled name and date of birth must be affixed to the patient's wrist or ankle prior to draw. Patients improperly identified will have 10 minutes (or less depending on phlebotomists time availability) to be properly banded prior to collection. Orders involving patients improperly ID banded, refusal of draw, already drawn, canceled by provider, patient discharged, and patient expired, nurse draw required (IV), phlebotomy attempted 2x by 2 phlebotomists, no site available, and patient unavailable x2 attempts will be canceled in Epic with an appropriate cancellation comment. In the event of cancellation, the patient's RN will be verbally notified of the canceled order(s) whenever possible. Phlebotomy may request patient hold assistance, heparin drips and IV's turned off prior to draw, or verbal identification prior to collection if the patient is unable to self identify.