Inpatient phlebotomy is a 24/7 service for all adult and pediatric non-intensive care units. This service only collects blood specimens for all routine and PRN draws orders that are made via 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. Refusal of phlebotomy collection by the patient or provider will result in the cancellation of the order and nursing will always be notified of this action. If any patient is unavailable for specimen collection, one reasonable attempt to return to the patient will be made unless that non-availability is expected to last more than a few minutes. Cancellation of orders will occur in any of the following circumstances: patient is missed by 2 phlebotomists twice (missed x2), patient unavailable x2, patient expired, patient refusal, or provider cancellation. Phlebotomy can use RN/provider printed labels when a unit collection has been unsuccessful. Phlebotomy cannot initiate an "Add on" order to an already collected specimen, whether the specimen is in the lab or in hand. Add On orders are completed by provider staff using the "Add on" icon in Epic from the received specimen in Core lab.
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, 0600, 0800, 1000, 1200, 1400, 1600, 1800, 2000, 2200, 0000 and 0200. The 0500 (morning draw that begins at 0305) 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 handheld "Rover" devices and mobile 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
All inpatient orders with an order class of: Collect Now, PRN, or Once are collected 24/7 by paging "Float Phlebotomy" via Vocera at 4-9809, and must be called at least 30 minutes ahead of the desired collection time. Draws will be collected in the order they are received or prioritized by patient need, as communicated by patient RN to phlebotomy. Unit Collect orders must be "toggled" in Epic to Lab Collect before phlebotomy float is called. Failure to "toggle" orders to Lab Collect will result in delay of collection. If collection is needed immediately, the RN can Vocera "Float Phlebotomy" to inquire if available; and if not, the RN must collect the 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, patient expired, nurse draw required (IV), phlebotomy attempted x2 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 to be paused prior to draw, or verbal identification prior to collection if the patient is unable to self identify.