Improving Blood Sample Collection Practices in Medical Diagnostic Labs: Order of Draw, Tube Handling, and Quality Control Measures

Summary

• A medical diagnostic lab must follow a specific order of draw when collecting blood samples to prevent cross-contamination and ensure accurate results.
• Proper handling of blood tubes is crucial to maintaining sample integrity and preventing hemolysis, clotting, and contamination.
• By following strict protocols and guidelines for order of draw and tube handling, medical labs can provide reliable test results and ensure patient safety.

Order of Draw

Order of draw refers to the sequence in which blood tubes are filled during the phlebotomy process. Following a specific order helps prevent contamination of samples with additives or anticoagulants from previous tubes, which can affect test results. The standard order of draw typically includes the following steps:

1. First draw: Blood culture tubes – These tubes are used to collect samples for microbiological testing and should always be collected first to prevent contamination with other additives.
2. Second draw: Coagulation tubes – Tubes containing citrate should be collected next to ensure accurate coagulation test results.
3. Third draw: Serum tubes – These tubes are used for chemistry tests that require a serum sample, such as glucose or cholesterol tests.
4. Fourth draw: Heparin tubes – Tubes containing heparin should be collected before tubes with EDTA to prevent interference with electrolyte tests.
5. Fifth draw: EDTA tubes – Tubes containing EDTA should be collected last to prevent anticoagulant contamination of other samples.

Handling of Blood Tubes

Proper handling of blood tubes is essential to ensure sample integrity and accurate test results. The following guidelines should be followed when handling blood tubes in a medical diagnostic lab:

1. Label all tubes correctly with patient information, date, and time of collection to prevent sample mix-ups.
2. Avoid vigorous shaking or agitation of tubes to prevent hemolysis, which can affect test results.
3. Store tubes at the appropriate temperature and protect them from light to prevent degradation of samples.
4. Ensure proper transportation of samples to the lab to minimize delays and maintain sample integrity.
5. Follow protocol for centrifugation and separation of samples to ensure accurate results for serum or plasma tests.

Quality Control Measures

In addition to following the order of draw and proper tube handling guidelines, medical diagnostic labs should implement quality control measures to ensure the accuracy and reliability of test results. These measures may include:

1. Regular calibration and maintenance of lab equipment to ensure accurate readings.
2. Participation in proficiency testing programs to monitor lab performance and identify areas for improvement.
3. Staff training and competency assessments to ensure proper technique and adherence to protocols.
4. Documentation of all procedures and processes to maintain traceability and accountability.
5. Adherence to regulatory guidelines and accreditation standards to ensure compliance with industry best practices.

By following the correct order of draw, handling blood tubes with care, and implementing quality control measures, medical diagnostic labs can provide accurate and reliable test results for patient care and treatment.

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