Assignment 4- 2

Instructor: Samantha. Deck

Course: HLT-317 V

Date: 11-12-17

IntroductionTitle of Paper belongs here with no bold

It is becoming a common problem across most healthcare facilities for healthcare practitioners to wrongly or fails altogether to label specimen. This often causes errors in laboratory services that result in reporting a wrong result that ultimately has potentially negative effects on the patient. This is prevalent particularly if there is a patient identification mix-up (Valenstein, Raab & Walsh, 2006). Under such circumstances, one patient may be given the wrong surgical or medical intervention that would further complicate the condition of the patient. Any potential adverse effects can lead to severe injuries or harm to the patient. Comment by samantha deck: Unclear antecedents seen throughout paper please revise Comment by samantha deck: Passive voice seen throughout paper revise sentences like this

Patients have lost their lives because of the mislabeling or failure to label specimen. In a situation where a particular specimen is not labeled, it becomes hard to distinguish it from other specimens as it easily leads to the wrong diagnosis.

I selected this topic because there are so many lives that have been lost while others have developed serious or adverse health complications because of failure to label specimen meant to help a patient receive better diagnosis and treatment. This topic is important especially for healthcare practitioners who are mandated to provide laboratory services. It helps in creating awareness and heightened sensitization about the need to uphold appropriate specimen labeling at all times. Comment by samantha deck: Refrain from using first person. Please refer to apa guidelines to see when to use first person vs third person

Specimen errors pose a severe threat to the safety and quality of care provided to patients in different facilities (Martin, Metcalfe, & Whichello, 2015). Therefore, healthcare practitioners must be sensitized the importance of specimen labeling.

This topic is very significant in the delivery of effective treatment to the patients in need of immediate medical intervention. The registered nurses and the laboratory personnel should come up with ways of reducing the specimen labeling errors. Proper labeling of the specimen is one way of ensuring that patients receive the right diagnosis and consequently appropriate prescriptions based on their illness.

How literature Review is used in Research

As demonstrated in most studies, errors or potential failure to label accurately specimen samples usually occurs in the pre-analytic phase. These apparent mistakes can be frustrating to the laboratory medical personnel since they usually happen outside the lab beyond their control (citation needed). However, as stated by researchers who have explored in detail this subject, putting in place appropriate policies, feedback, and education will reduce significantly and ultimately prevent specimen labeling errors in healthcare facilities (citation needed).

The selected studies include “Right Patient, Wrong Sample” by Astion (2006), “Specimen Labelling Errors: A Retrospective study” by Martin, Metcalfe and Whichello (2015), “Patient Safety in the Clinical Laboratory: A Longitudinal Analysis of Specimen Identification Errors” by Wagar et al. (2006) and “Identification Errors Involving Clinical Laboratories: a College of American Pathologists Q-Probes Study of Patient and Specimen Identification Errors at 120 Institutions” by Valenstein, Raab and Walsh (2006). They are used to provide a detailed background of this study as well as complement and support the topic. Comment by samantha deck: Wordy revise

As revealed in a study by Wagar et al. (2006) mislabeling of a specimen is quite expensive. For instance, he pointed that an average cost of a misidentified specimen is about seven hundred dollars, not taking into account the immeasurable costs such as the delays in treatment and diagnosis and patient anxiety and discomfort.

Detailed analysis of cases of specimen errors in these studies points to need to adopt correct patient identification for better diagnosis and treatment. Laboratory medical directors are expected to play a leading role in ensuring this is achieved to improve patient safety. They are required to review the guidelines for specimen rejection from time to time by making sure nurses and physicians adheres to the recommended guidelines.

These potential errors can be classified as pre-analytic, analytic or post-analytic. Lab service errors that occur before a specimen is analyzed are considered pre-analytic errors. This commonly happens due to mislabeling of specimens. Those errors which occur during automated or manual specimen analysis in the laboratory are considered analytic errors while the errors that occur after production of a lab result are considered post-analytic errors (Astion, 2006). Post-analytic errors are mostly caused by misreporting results by electronic, oral or written communication. As indicated in most literature about this topic, pre-analytic errors frequently occur in most health facilities. However, significant clinical errors can occur in all phases of testing, and as such healthcare practitioners should not assume only errors occur during the pre-analytic phase.

By reviewing these different pieces of literature about specimen errors, healthcare practitioners would get a better grasp on how to avoid similar errors in their day to day operations. It will help researchers find out why such errors occur, the rationale behind it, and the potential deficiencies that often takes place leading to the rejection of specimens.

Ethical considerations for data collection

The data collection for this research would incorporate appropriate ethical considerations. Selected participants to take part in this research would not be subjected to harm whatsoever. The researchers involved in this study would adhere to the recommended ethical standards at all times. The dignity of participants, patients affected by specimen errors while undergoing treatment, should be respected and prioritized by the researchers (Valenstein, Raab & Walsh, 2006). Researchers are expected to seek the full consent of the participants before commencing the study.

The researchers are required to uphold and maintain utmost protection of privacy to avoid exposing and revealing the details of the participants to the public (Valenstein, Raab & Walsh, 2006). At no point whatsoever should their identities revealed either in research reports or oral presentation of the study. Researchers are expected to maintain an adequate level of confidentiality of the research data. Individual identities of participants or organization involved should be made anonymous to protect the confidentiality of information presented.

Researchers are expected to avoid any potential exaggeration or deception about the objectives or aims of the research. In the event of a possible conflict of interest during the process of collecting data, researchers are expected to declare them without undue delay or bias. Also, all sources of funding, any forms of affiliations as well as any communication should be revealed with utmost transparency and honesty.

Statistical Analysis

The statistical analysis for this research would be based on a comparison between the participants who had errors in their specimen and those participants whose specimen samples were accurate. A comprehensive analysis would be carried out to access the potential variation in the results between the two groups. This is intended to ascertain whether the differences are real and not a result of chance. Confidential Interval (CI) and p values are used to carry out the analysis to measure the statistical significance.

Based on the results of previous studies on this topic, errors of patients’ specimen vary significantly making it difficult to compare the results. This is due to large variation in error detection methods and error definitions. However, it is apparent when undertaking this statistical analysis that patients whose specimen has errors are more than likely to experience poor treatment. The test results would indicate a completely different diagnosis of patients’ illness that would lead to a wrong prescription. As a result potential injuries or harm is inflicted on the patient.

The expected negative impact of the wrong diagnosis due to specimen errors calls for appropriate actions to be taken by healthcare management to improve laboratory testing process. As shown through different statistical analysis, healthcare facilities should identify and apply the best practices to improve patient diagnosis. They should adopt consistent methods to provide benchmark error rates to check on the potential mistakes during the extensive laboratory testing process. This involves providing monitoring errors on submission of unacceptable specimens.

Use of wristband on patients to monitor their identities has been proven in different studies to reduce potential specimen errors effectively. For instance, 217 health facilities in the United States which adopted the use of patients’ wristbands recorded a reduction of four percent specimen errors in two years (Astion, 2006). On the other hand, patients who did not use wristband recorded 72 percent specimen errors; this was the group with the highest exposure rate. Effectiveness of specific study Comment by samantha deck: Paragraph needs to start at the left margin, paragraph is centered

The study by Astion (2006) provided sufficient information which proved specimen errors can be detected in several ways that include the use of error checking protocols within the lab, incident reports from inside or outside the lab and paying close attention to caregiver complaints.

This study reveals the prevalent cases of mislabeling of specimens which if health care practitioners take appropriate measures can be detected early enough before the specimen is run and released. The author of this study suggested the use of two methods, patient identifiers, and delta checking, to detect these errors. If adopted, the potential error rates would decrease by 85 percent. Most of the errors would be detected by lab technicians immediately after the specimen have been taken to the lab. The technicians are required first to check whether the two patients’ identifiers match with the two identifies on the specimen. Any potential mismatch or failure to provide correct labels on the specimen leads to test cancellation and caregiver notification.

The second method depicted in this study involves the use of ‘delta checking’ to detect mislabeling of a specimen. It is an automated comparison of the patients’ current and previous test value, which is carried out using the laboratory information system (Astion, 2006). As demonstrated in this study, if the ‘delta’ values are higher than a defined limit, the outcome should be flagged and a procedure put in place to ascertain if an error occurred. By consistently applying these methods, a remarkable decrease of potential specimen errors would be realized.

Conclusion

As demonstrated in this literature review, it is apparent that specimen errors contribute to the wrong diagnosis of patients. This, if not detected early enough, may lead to the prescription of wrong medication that can injure or harm the affected patients. Therefore, appropriate detection methods such as delta checking and patients’ identifiers should be used to avoid unnecessary loss of patients’ life.

Please make sure that if you are placing your opinion that you back it up with a citation to make it a fact. I have placed citation needed by a couple of these sentences. I did not identify all the sentences that need citations, please ensure to review your paper for this issue and correct for final paper.

References Comment by samantha deck: References incorrectly written

Astion, M. (2006). Right Patient, Wrong Sample. Laboratory Errors and Patient Safety

NewsletterUniversity of Washington, Department of Laboratory Medicine

Martin, H., Metcalfe, S., & Whichello, R. (2015). Specimen Labeling Errors: A Retrospective

Study. Online Journal of Nursing Informatics.

Valenstein. P.N., Raab, S.S. & Walsh M.K. (2006). Identification errors involving clinical

laboratories: a College of American Pathologists Q-Probes study of patient and specimen identification errors at 120 institutions. Arch Pathol Lab Med. 130:1106–1113

Wagar, E.A., Tamashiro, L., Yasin, B., Hilborne, L. & Bruckner, D.A. (2006). Patient safety in

the clinical laboratory: a longitudinal analysis of specimen identification errors. Arch Pathol Lab Med. 130:1662–1668.