Quality in Medical Labs
Subject: Other Medical Specialties
In the article entitled Strict adherence to a Blood Bank Specimen Labeling Policy by all clinical laboratories significantly reduces the incidence of ‘wrong blood in tube’, the authors investigate phlebotomy errors that may be occasioned by poor labeling of blood specimens. This error is usually carried forward to wrong transfusions when patients receive mislabeled blood samples that are not compatible with their blood groups. According to the authors, a number of morbidity and mortality cases have been reported in various medical settings as a result of incompatible transfusions. A labeling policy used in the authors’ institution entails three main requirements. First, the collection date of the blood sample must be clearly indicated. Needless to say, this is a key factor to consider when receiving blood specimens from donors. Second, two unique patient identifiers are also needed and lastly, there should be a clear mechanism in place to determine the phlebotomist. These requirements were initially reinforced by blood banks. However, recent developments have witnessed the same requirements being applied even at the local clinical settings.
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The authors also observe that ever since the specimen-labeling policy was embraced and adopted across the board, instances of ‘wrong blood in tube’ have been reduced significantly. In fact, the percentage reduction stands at 73.5%. The authors are also emphatic that both a change in policy and educational initiatives can remarkably minimize errors related to ‘wrong blood in tube.’ It is apparent that blood banks usually receive several cases of mislabeled blood specimens. From the above article, the authors are emphatic that incompatible RBC transfusions usually account for almost 13% of phlebotomy errors. However, the article is purely qualitative in nature since there are no empirical studies that support the same assertions. While we may generally concur with the claim that poor labeling of blood specimens is the main cause of phlebotomy errors, it is crucial to consider other underlying causes such as poor working equipment, lack of adequate and competent medical personnel in blood transfusion centers and occasional medical errors caused by mass handling of specimens. Apart from just proper labeling of blood specimens, clinical officers should also consider using hand-held scanners and patient wristbands. The authors propose the use of radiofrequency identification technology. This method is indeed very effective since a patient’s record can be easily captured in a computer system and then matched with the blood specimen. However, the authors fail to underscore the fact that this method may not be readily available or affordable in some medical settings and jurisdictions. For instance, a radiofrequency machine is still a dream pipe in most low-income economies. When proposing such a hi-tech technique for identifying blood specimens, the authors should have also included cheaper, more affordable and accessible options for ensuring that blood specimens are not mismatched with the patients. Nevertheless, a better section of the article covers relevant piece of information that can aid in minimizing labeling errors. In fact, blood bank employees should be thoroughly trained on how to handle, read and interpret blood specimens. The materials and methods used in the study are relevant. For example, creating regular incident reports is a crucial procedure highlighted in the methods section. From the results, it is evident that stricter labeling policy can reduce instances of phlebotomy errors. In addition, the article has cited some of the most authoritative medical literatures that contain sound information. These include peer reviewed medical journals and books as well as government publications.