Wait for patient safety officer to ask first question…
Phlebotomist Response 1: There’s a few important things to know. We have five Med-Surg units. I looked at some data before our meeting. In the past 6 months, on an average morning, we draw blood from 72 patients in order to send the 136 labs that are ordered. The morning labs are ordered for the 5:30 AM “bulk draw”, meaning all the labs get drawn then sent down for processing at the same time. The order labels that we stick on the tubes for all the “bulk draws” print in the phlebotomy team room at 4:30 AM. The night shift phlebotomists each choose five patients at their own discretion on which to draw labs. The remainder of the labs are then collected by the day team.
Wait for patient safety officer to ask second question…
Phlebotomist Response 2: Yes and no. The night shift phlebotomists pick the easy patients. You know, the patients with a PICC line who therefore don’t require an IV stick. They also count an attempted draw as one patient, even if they were not successful. For instance, if the patient was a hard stick or they were off the floor or in the bathroom, that “counts” as a draw in their eyes. What’s left after the five attempts per night phlebotomist is split up amongst the day staff. We try to divide by floor, assigning each phlebotomist their own unit. When we arrive at 5:00 AM, we get our assignment, prep the lab draw cart in the team supply room and head off to begin collections by 5:30 AM.
Wait for patient safety officer to ask third question…
Phlebotomist Response 3: Our manager recently did observations of the whole morning and recorded what a morning looks like for one phlebotomist. I have some of that data here with me. With so many patients to draw, little delays here and there add up quickly, like having to start a new IV or draw blood cultures. Oh, and almost every day I get called for a “stat” lab that I’m almost certain is because someone forgot to order it on time.
Wait for patient safety officer to ask fourth question…
Phlebotomist Response 4: This is where our technology limits us. Because all the “morning labs” print at one time, the 5:30 AM “bulk draw” labs are all processed by the lab at the same time, so we send them down together via the tube system once we have drawn all of them.