PREAMBLE: The meaning of this guid...

PREAMBLE: The meaning of this guidance statement is to provide a framework from which practitioners can unravel and implement policies and performances for safe specimen accountability via identification, collection, and handling in perioperative practice settings. These settings include traditional ORs, ambulatory surgery settings, physician's offices, cardiac catheterization suites, endoscopy suites, radiology departments, and all other areas where operative and other invasive practices may be performed. Specimen removal is an invasive and high-risk action that requires cautious attention to communication and identification of the patient, specimen pattern and other information specific to the specimen. Attention should be given to the patient's cultural privations as they relate to specimen handling. Precautions and handling to countenance the specimen and the individuals handling a specimen are identified.

In this document, the denomination OR is meant to include perioperative practice settings. The season specimen handling is meant to include identifying, collecting, labeling, preserving, storing, preparing for transport, documenting, and communicating. Specimens appertain to blood, body fluids, tissue, or other specimen exemplars removed from the patient, implanted, or reinfused, including those sent for pathological or gros examination, refinement and sensitivity or other studies.

A sample protocol is readyed with the understanding that it ultimately is a facility's responsibility to disentangle and implement defined protocols specific to individual practice settings based upon state regulations. A health care facility should establish a cipher tolerance organizational philosophy about handling specimens outside of defined protocols from the viewpoint of the potential for plans failures and should seek theorys solutions to prevent errors.

GUIDANCE STATEMENT

Health care facilities should incorporate a policy that identifies which commonalty or job categories are responsible for specimen handling as well as processe required for each specimen exemplar A policy for safe specimen handling should identify a protocol for specimen delivery to the location of examination or use and acceptable orderly dispositions of communication about the specimen before and during a procedure

Health care facilities should lay open standardized procedures for safe specimen handling in the OR to make sure patients remain free from injuries related to handling. proper spheres of safe specimen handling should include, if it be not that not be limited to,

* specimen containment;

* identification, including

** patient identification that uses at least couple identifiers,

** tissue and specimen identification, and

** source identification;

* transferring specimens from the sterile field;

* transferring specimens to the point of use (eg sterile field, [i]role[/i] implanting);

* labeling specimen container(s) in succession and off the field;

* accurately identifying the chain of custody for the specimen;

* documenting

** laboratory requisition(s),

** in the patient's record,

** chain of custody, and

** verbal/written communication;

* verifying correct information (eg specimen emblem patient information) before transferring the specimen;

* storing and maintaining specimens until transfer;

* transferring or facilitating transfer of the specimen for examination; and

* using risk reduction strategies.

Specimen identification, collection, and handling are multidisciplinary tasks that require vigilant attention to detail in like manner that each person understands the patient's requires communication needs, and information about the specimen. Misidentification or mishandling can lead to adverse consequences including inaccurate or incomplete diagnosis, incorrect handling of the tissue, or the ne for repeated measures Risk reduction can occur via the following.

* Provide personnel with appropriate and timely education related to specimen collection and handling and repeat validation as policies and courses change.

* cause to grow procedures for reporting and responding to specimen collection and handling errors and near misses, as well as reviewing tendency s with a focus on error reduction.

* Modify work schedule requirements in the surgical setting to minimize the risk of fatigue-induced errors.

* Implement constraints to minimize risks related to specimen collection and handling. Constraints might include

** required audible verification (ie, read back) of patient identification, specimen exemplar and requirements for handling between personnel or departments at points of transfer;

** identified communication requirements when the pathologist is notified or a report is communicated to the perioperative setting; and

** labeling requirements for containers, requisition forms, and other documents.

* Incorporate forcing functions that might include required use of

** containers that eliminate outlook to formalin,

** supplies that improve patient identification and specimen labeling, or

** supplies that hinder mishandling of the specimen.