Collect the Wednesday morning pathology list

What is going on

The Wednesday morning list at Toronto has nine patients between 7:00 am and 9:30 am, with the courier at 9:40 am. The list includes a fasting lipid and glucose patient who admits to having had coffee with milk, a patient on warfarin for a coagulation profile, a four-year-old in the children's room whose parent is anxious, a chain of custody urine drug screen for a pre-employment medical and a vitamin B12 that must be protected from light. On 2 September the laboratory rejected an unlabelled tube collected by a trainee, and the supervisor is now observing identification and labelling at the chair for every patient. One patient reports that they fainted at their last collection.

Your brief

Prepare the room, identify every patient with two identifiers, check each request, collect and label each specimen at the chair in the correct draw order, manage the special cases on the list, record every collection in the Pathology Specimen Register and pack the courier bag on time.

Work through it

You do not need to do it all. Doing a few of these will show you what the work is like. Your ticks and notes stay on this device.

• Read the Venous Blood Collection and Specimen Handling Procedure and the Hand Hygiene and Standard Precautions Procedure and write out the draw order and the labelling rule.
• Set up the collection room and the children's room, check sharps container levels, stock and the spill kit, and record the checks.
• For the fasting patient who had coffee with milk, decide with your supervisor whether the collection proceeds, and record the fasting status and the decision on the request and in the register.
• For the patient with a fainting history, describe the positioning and precautions you take and what you would do if they fainted during the collection.
• Collect the coagulation profile for the warfarin patient, describing tube fill and inversion, and record the specimen in the register with the storage requirement.
• Complete the chain of custody urine drug screen with the witnessing and sealing steps recorded, and enter it in the register.
• Label every tube at the chair before the patient leaves and record the collector identifier, then prepare the courier bag with the specimens sorted by storage requirement and the vitamin B12 protected from light.
• Record the courier pick-up in the register for every specimen and enter any adverse event or near miss from the session in the Clinical Incident and Hazard Register.

What someone in this role would produce

• Nine entries in the Pathology Specimen Register with storage and despatch recorded
• Room set-up and stock check record
• Written decision on the non-fasting patient
• Courier bag manifest
• Incident register entry if any event occurred