Ori Prereq Ch 5 - RN

Specimens

• Save all specimens, and always wear gloves when handlingspecimens or containers with specimens
• Each specimen bag must contain only one patient’s specimen(specimens from multiple patients should never be mixed in the same bag)
• Each specimen container must hold only one specimen and every individualspecimen container/tube must have a label adhered or it will be rejected(not loose in the bag)
• Label only one container at a time, and do NOT pre-label containers
• Circulator, scrub person, and surgeon are responsible for performing positive patient identification and naming anatomic specimens correctly

• Surgeon: Confirms name of the surgical specimen
• Circulator and scrub person: Performs the two-person specimen verification and collection (one preparing the ADT label, and one verifying its accuracy)

Specimens

Specimens

• Explants are never released directly to the patient/family
• Release forms are filled out by the circulator to accompany specimen to Anatomic Pathology who will later release it to the patient
• Forensic specimens are never released directly to the police
• Always deposit these in the lock box at the Anatomic Pathology desk
• Anatomic Pathology releases these specimens to a properly-identified legal authority and documents chain of custody and the nature of the material released
• Forensic specimens have specific handling requirements
• Bullets must not be marked by the surgeon (doing so can interfere with ballistics or other evidence)

• Oncologic breast specimens must be delivered within 30 minutes of removal and:
• Before 5:30pm on Tuesday, Thursday, and Friday
• Before 7:30pm on Monday and Wednesday

• For eStar/Epic orders, place a separate order for specimens going to different places (Anatomical Pathology and Clinical Pathology) or for specimens that need to go to the lab at different times (routine specimens and frozen specimens)

Intra-op Electronic Lab Ordering

• Use the Preference List within the Orders activity to place the most common specimen orders

LRL

Intra-op Electronic Lab Ordering

Clinical Pathology (Labs) & Blood Bank

• The approved workflow for these specimens in the OR:

1. Anesthesia/circulator orders the appropriate lab and draws the specimen
2. The circulator prints the lab-ready label and gives to anesthesia

• Acknowledge all orders in the Orders function
• Under the Labs/Test tab, click the Print Label link to print the LRL to give to anesthesia

3. Anesthesia labels the specimen and completes the collection in eStar/Epic

• The person drawing the specimen should complete the collection steps
• Click the Collect link
• Affix the lab-ready label to the specimen tube properly (and DO NOT write on the label for Clinical Pathology)
• Scan the patient’s armband or override scanning

• Scan the lab-ready label of the specimen (and complete dual sign-off steps for Blood Bank specimens)
• Click Accept

4. The circulator will finish steps to send specimen to appropriate destination

• For blood bank and cytopathology specimens, retrieve the lab requisition that prints to the mapped printer
• Place the labeled specimen and printed requisition in a biohazard bag and send to the lab

Intra-op Electronic Lab Ordering

Anatomic Pathology

• The approved workflow for these specimens in the OR:

1. Select the appropriate Surgical Pathology order: Intra-op Surgical Pathology (LAB6541)
2. Label the specimen with the patient ADT label and write only the specimen name on the label
3. Complete the order form in eStar/Epic
4. Once the order is signed, the requisition will automatically print to the mapped printer
5. Send the labeled specimen and printed requisition to Anatomic Pathology

• No LRL will be printed

• Breast and pediatric solid tumor specimens have timing instructions if answered “Yes” (and pediatric solid tumor opens an additional question)

• Do not sign the order until you are ready to send the specimen to Pathology

Downtime Paper Requisitions

By Specimen Type

Anatomic Pathology Window

Type & Screen

• VUMC policy reflects standards set forth by the Association for the Advancement of Blood and Biotherapies (AABB)
• If a patient arrives to the OR without both a Type & Screen within 72 hours and a historical type & screen at the VUMC campus they are admitted to, the collection of two separate Type & Screen specimens is required
• The two separate Type & Screen specimens must be either:

• Venous collections must be from two different times and sites
• Samples can be drawn in one session at least one minute apart if from a central line

• The requisition auto-prints to mapped printed and will have a space for dual sign-off (next slide)

Type & Screen

• Two signatures are required on the Type & Screen requisition

CollectorVUMC IDTime if different

The collector (anesthesia provider) fills out the specimen label (which must include the collection date and their VUMC ID) and this section of the form

Type & Screen

• Two signatures are required on the Type & Screen requisition

The verifier (circulator) reviews the specimen label and chart, confirming the patient’s identity, and confirms that the specimen label is applied to the tube properly

CollectorVUMC IDTime if different

Blood Product Verification

• Two licensed, trained staff members complete the blood product verification including:

• Patient consent to receive blood products
• Visually and audibly verifying blood product compatibility label matches:
• Physician’s verbal order including any special restrictions (irradiation, antigen negative, etc.)
• Patient identity (patient sticker and Flight board)
• The transfusion administration record (TAR)

• The two staff members must also check to ensure the transfusion is initiated prior to expiration (date and time) on the product

• If administering uncross-matched trauma blood, confirm the donor unit identification number and the donor blood type

• Documentation as witness:

• Both staff members sign the chart copy of the physical TAR must remain with the patient throughout the transfusion
• Witness enters credentials in eStar when TAR is electronic

Blood Verification Process Illustration

Blood Product Verification

Blood OrderVerificationin Epic

Wound Class

• Wound class documentation should be correct, consistent, and reliable
• Reclassify wounds as the status changes during the procedure

Wound Vacs

• When wound vacs are discontinued:

• The power cord must remain with the machine
• The canister is removed and placed in a biohazard bag (NOT the entire unit)
• The machine must be placed on the shelf in the soiled utility room in Main PACU (room 3125 E, NOT the core)

• These units and their specialty power cords are very expensive

Isolation

• In preparation for the case:

• Remove all unnecessary equipment
• Use sheets to cover all equipment that you cannot remove
• Close and tape all cabinets per policy
• Cannot open cabinets during the case (or all items within the cabinet are considered contaminated)
• Order isolation cart from Central Supply and place it in the hallway (“clean” side unless the isolation is airborne)

Isolation

• During the case:

• Have proper signage displayed on all entrances to the OR suite
• Don appropriate PPE
• Keep isolation cart in the hallway
• The runner, assigned by the CSL or Board Charge Nurse, remains delivers anything from outside the room that the teams needs and monitors the blood cooler (if present) – they do not enter the OR

Isolation

• After transferring the patient to the OR bed and before rolling the stretcher/bed into the hallway:

• All bed linens are removed
• A plastic sheet is placed over the bed
• An isolation sticker is placed on the plastic

• After any isolation case, the room is cleaned with bleach wipes due to the sporicidal effect
• For airborne precautions:

• Wear an N95 respirator (individually-fitted) during the entire case (except during the time when the patient is intubated)
• The runner must only transfer items to in-room staff through the hallway (“dirty” side) door to avoid contamination in the core
• PSTs and others wear N-95 during room turnover
• All ORs must remain vacant for 18 minutes (99% room air change)

• Isolation carts are placed in the hallway outside the OR area by the C elevators (the same hallway that leads to the main OR breakroom)

Chapter Complete!

References

[SOP] Patient Identification (Periop)

[SOP] Airborne Precautions

[SOP] Handling of Surgical Specimens

[SOP] Contact Precautions

[SOP] Labeling of Laboratory Specimens

[SOP] Droplet Precautions

[Policy] Submission of Surgical Specimens to Pathology

[SOP] Infection Prevention Interventions to Prevent Transmission of COVID-19 Infection

[VUMC2Go Tip Sheet] Electronic Ordering of Labs

Vanderbilt Medical Laboratories Test Directory

[VUMC2Go Tip Sheet] Collecting a Blood Bank Specimen - HR/PACU and Procedural Areas

[Policy] Blood Product Administration

[SOP] Blood Products: Non-emergent, Massive Transfusion Protocol (MTP), and Isolation

[VUMC2Go Tip Sheet] Administering Blood: The Guide

[Policy] Isolation Precaution Procedures for Operating Room Patients

[Policy] Isolation – Infection Control Precautions to Prevent Transmission of Contagious Infections

[SOP] Isolation Room Cleaning

Blood Verification Process

Verify patient name and medical record number (MRN) on their armband and sticker with the Flightboard. The sticker now becomes the identifier for blood product verification.

Compare the compatibility label with the patient sticker. Compare the compatibility label with the TAR. Compare the blood product label with the compatibility label attached.

Compare the TAR with the blood product cooler. Verify special attributes/restrictions for the blood order. Confirm the transfusion initiated prior to the expiration date and time.

One healthcare professional reads patient and blood product information while the second healthcare professional listens and then performs their own check.

The roles are then reversed, with the second person reading and the first person verifying, ensuring a thorough check.

Larger images on next slide

The process is only complete when all information (patient name, date of birth, medical record number, unit number, blood type, expiration date, blood product type) matches across all documents and the patient.

Wound Vac Return

References

[SOP] Patient Identification (Periop)

[SOP] Airborne Precautions

[SOP] Handling of Surgical Specimens

[SOP] Contact Precautions

[SOP] Labeling of Laboratory Specimens

[SOP] Droplet Precautions

[Policy] Submission of Surgical Specimens to Pathology

[SOP] Infection Prevention Interventions to Prevent Transmission of COVID-19 Infection

[VUMC2Go Tip Sheet] Electronic Ordering of Labs

Vanderbilt Medical Laboratories Test Directory

[VUMC2Go Tip Sheet] Collecting a Blood Bank Specimen - HR/PACU and Procedural Areas

[Policy] Blood Product Administration

[SOP] Blood Products: Non-emergent, Massive Transfusion Protocol (MTP), and Isolation

[VUMC2Go Tip Sheet] Administering Blood: The Guide

[Policy] Isolation Precaution Procedures for Operating Room Patients

[Policy] Isolation – Infection Control Precautions to Prevent Transmission of Contagious Infections

[SOP] Isolation Room Cleaning

References

[SOP] Patient Identification (Periop)

[SOP] Airborne Precautions

[SOP] Handling of Surgical Specimens

[SOP] Contact Precautions

[SOP] Labeling of Laboratory Specimens

[SOP] Droplet Precautions

[Policy] Submission of Surgical Specimens to Pathology

[SOP] Infection Prevention Interventions to Prevent Transmission of COVID-19 Infection

[VUMC2Go Tip Sheet] Electronic Ordering of Labs

Vanderbilt Medical Laboratories Test Directory

[VUMC2Go Tip Sheet] Collecting a Blood Bank Specimen - HR/PACU and Procedural Areas

[Policy] Blood Product Administration

[SOP] Blood Products: Non-emergent, Massive Transfusion Protocol (MTP), and Isolation

[VUMC2Go Tip Sheet] Administering Blood: The Guide

[Policy] Isolation Precaution Procedures for Operating Room Patients

[Policy] Isolation – Infection Control Precautions to Prevent Transmission of Contagious Infections

[SOP] Isolation Room Cleaning

References

[SOP] Patient Identification (Periop)

[SOP] Airborne Precautions

[SOP] Handling of Surgical Specimens

[SOP] Contact Precautions

[SOP] Labeling of Laboratory Specimens

[SOP] Droplet Precautions

[Policy] Submission of Surgical Specimens to Pathology

[SOP] Infection Prevention Interventions to Prevent Transmission of COVID-19 Infection

[VUMC2Go Tip Sheet] Electronic Ordering of Labs

Vanderbilt Medical Laboratories Test Directory

[VUMC2Go Tip Sheet] Collecting a Blood Bank Specimen - HR/PACU and Procedural Areas

[Policy] Blood Product Administration

[SOP] Blood Products: Non-emergent, Massive Transfusion Protocol (MTP), and Isolation

[VUMC2Go Tip Sheet] Administering Blood: The Guide

[Policy] Isolation Precaution Procedures for Operating Room Patients

[Policy] Isolation – Infection Control Precautions to Prevent Transmission of Contagious Infections

[SOP] Isolation Room Cleaning

Class II: Clean-Contaminated

Enters a tract* under controlled conditions, no unusual contamination occurs) Appendectomy, liver or kidney transplant, cholecystectomy, C-section, otolaryngology, gastric surgery, GU or GYN surgery, colorectal surgery (Class II as of 2012)

Clinical Labs

Cultures (Microbiology/Virology)

Barcode Scanning

Barcode scanning is valid PPID. If the patient's armband cannot be scanned, a dual sign-off requisition must be completed for each sample.

References

[SOP] Patient Identification (Periop)

[SOP] Airborne Precautions

[SOP] Handling of Surgical Specimens

[SOP] Contact Precautions

[SOP] Labeling of Laboratory Specimens

[SOP] Droplet Precautions

[Policy] Submission of Surgical Specimens to Pathology

[SOP] Infection Prevention Interventions to Prevent Transmission of COVID-19 Infection

[VUMC2Go Tip Sheet] Electronic Ordering of Labs

Vanderbilt Medical Laboratories Test Directory

[VUMC2Go Tip Sheet] Collecting a Blood Bank Specimen - HR/PACU and Procedural Areas

[Policy] Blood Product Administration

[SOP] Blood Products: Non-emergent, Massive Transfusion Protocol (MTP), and Isolation

[VUMC2Go Tip Sheet] Administering Blood: The Guide

[Policy] Isolation Precaution Procedures for Operating Room Patients

[Policy] Isolation – Infection Control Precautions to Prevent Transmission of Contagious Infections

[SOP] Isolation Room Cleaning

Intra-op Surgical Pathology Order

References

[SOP] Patient Identification (Periop)

[SOP] Handling of Surgical Specimens

[SOP] Labeling of Laboratory Specimens

[Policy] Submission of Surgical Specimens to Pathology

[VUMC2Go Tip Sheet] Electronic Ordering of Labs

Vanderbilt Medical Laboratories Test Directory

[VUMC2Go Tip Sheet] Collecting a Blood Bank Specimen - HR/PACU and Procedural Areas

[Policy] Blood Product Administration

[SOP] Blood Products: Non-emergent, Massive Transfusion Protocol (MTP), and Isolation

[VUMC2Go Tip Sheet] Administering Blood: The Guide

[Policy] Isolation Precaution Procedures for Operating Room Patients

[Policy] Isolation – Infection Control Precautions to Prevent Transmission of Contagious Infections

[SOP] Isolation Room Cleaning

Transfusionists

References

[SOP] Patient Identification (Periop)

[SOP] Airborne Precautions

[SOP] Handling of Surgical Specimens

[SOP] Contact Precautions

[SOP] Labeling of Laboratory Specimens

[SOP] Droplet Precautions

[Policy] Submission of Surgical Specimens to Pathology

[SOP] Infection Prevention Interventions to Prevent Transmission of COVID-19 Infection

[VUMC2Go Tip Sheet] Electronic Ordering of Labs

Vanderbilt Medical Laboratories Test Directory

[VUMC2Go Tip Sheet] Collecting a Blood Bank Specimen - HR/PACU and Procedural Areas

[Policy] Blood Product Administration

[SOP] Blood Products: Non-emergent, Massive Transfusion Protocol (MTP), and Isolation

[VUMC2Go Tip Sheet] Administering Blood: The Guide

[Policy] Isolation Precaution Procedures for Operating Room Patients

[Policy] Isolation – Infection Control Precautions to Prevent Transmission of Contagious Infections

[SOP] Isolation Room Cleaning

Orders Needing Specimen Collection

References

[SOP] Patient Identification (Periop)

[SOP] Airborne Precautions

[SOP] Handling of Surgical Specimens

[SOP] Contact Precautions

[SOP] Labeling of Laboratory Specimens

[SOP] Droplet Precautions

[Policy] Submission of Surgical Specimens to Pathology

[SOP] Infection Prevention Interventions to Prevent Transmission of COVID-19 Infection

[VUMC2Go Tip Sheet] Electronic Ordering of Labs

Vanderbilt Medical Laboratories Test Directory

[VUMC2Go Tip Sheet] Collecting a Blood Bank Specimen - HR/PACU and Procedural Areas

[Policy] Blood Product Administration

[SOP] Blood Products: Non-emergent, Massive Transfusion Protocol (MTP), and Isolation

[VUMC2Go Tip Sheet] Administering Blood: The Guide

[Policy] Isolation Precaution Procedures for Operating Room Patients

[Policy] Isolation – Infection Control Precautions to Prevent Transmission of Contagious Infections

[SOP] Isolation Room Cleaning

References

[SOP] Patient Identification (Periop)

[SOP] Airborne Precautions

[SOP] Handling of Surgical Specimens

[SOP] Contact Precautions

[SOP] Labeling of Laboratory Specimens

[SOP] Droplet Precautions

[Policy] Submission of Surgical Specimens to Pathology

[SOP] Infection Prevention Interventions to Prevent Transmission of COVID-19 Infection

[VUMC2Go Tip Sheet] Electronic Ordering of Labs

Vanderbilt Medical Laboratories Test Directory

[VUMC2Go Tip Sheet] Collecting a Blood Bank Specimen - HR/PACU and Procedural Areas

[Policy] Blood Product Administration

[SOP] Blood Products: Non-emergent, Massive Transfusion Protocol (MTP), and Isolation

[VUMC2Go Tip Sheet] Administering Blood: The Guide

[Policy] Isolation Precaution Procedures for Operating Room Patients

[Policy] Isolation – Infection Control Precautions to Prevent Transmission of Contagious Infections

[SOP] Isolation Room Cleaning

References

[SOP] Patient Identification (Periop)

[SOP] Airborne Precautions

[SOP] Handling of Surgical Specimens

[SOP] Contact Precautions

[SOP] Labeling of Laboratory Specimens

[SOP] Droplet Precautions

[Policy] Submission of Surgical Specimens to Pathology

[SOP] Infection Prevention Interventions to Prevent Transmission of COVID-19 Infection

[VUMC2Go Tip Sheet] Electronic Ordering of Labs

Vanderbilt Medical Laboratories Test Directory

[VUMC2Go Tip Sheet] Collecting a Blood Bank Specimen - HR/PACU and Procedural Areas

[Policy] Blood Product Administration

[SOP] Blood Products: Non-emergent, Massive Transfusion Protocol (MTP), and Isolation

[VUMC2Go Tip Sheet] Administering Blood: The Guide

[Policy] Isolation Precaution Procedures for Operating Room Patients

[Policy] Isolation – Infection Control Precautions to Prevent Transmission of Contagious Infections

[SOP] Isolation Room Cleaning

References

[SOP] Patient Identification (Periop)

[SOP] Handling of Surgical Specimens

[SOP] Labeling of Laboratory Specimens

[Policy] Submission of Surgical Specimens to Pathology

[VUMC2Go Tip Sheet] Electronic Ordering of Labs

Vanderbilt Medical Laboratories Test Directory

[VUMC2Go Tip Sheet] Collecting a Blood Bank Specimen - HR/PACU and Procedural Areas

[Policy] Blood Product Administration

[SOP] Blood Products: Non-emergent, Massive Transfusion Protocol (MTP), and Isolation

[VUMC2Go Tip Sheet] Administering Blood: The Guide

[Policy] Isolation Precaution Procedures for Operating Room Patients

[Policy] Isolation – Infection Control Precautions to Prevent Transmission of Contagious Infections

[SOP] Isolation Room Cleaning

Cytology

References

[SOP] Patient Identification (Periop)

[SOP] Airborne Precautions

[SOP] Handling of Surgical Specimens

[SOP] Contact Precautions

[SOP] Labeling of Laboratory Specimens

[SOP] Droplet Precautions

[Policy] Submission of Surgical Specimens to Pathology

[SOP] Infection Prevention Interventions to Prevent Transmission of COVID-19 Infection

[VUMC2Go Tip Sheet] Electronic Ordering of Labs

Vanderbilt Medical Laboratories Test Directory

[VUMC2Go Tip Sheet] Collecting a Blood Bank Specimen - HR/PACU and Procedural Areas

[Policy] Blood Product Administration

[SOP] Blood Products: Non-emergent, Massive Transfusion Protocol (MTP), and Isolation

[VUMC2Go Tip Sheet] Administering Blood: The Guide

[Policy] Isolation Precaution Procedures for Operating Room Patients

[Policy] Isolation – Infection Control Precautions to Prevent Transmission of Contagious Infections

[SOP] Isolation Room Cleaning

Blood Bank

References

[SOP] Patient Identification (Periop)

[SOP] Airborne Precautions

[SOP] Handling of Surgical Specimens

[SOP] Contact Precautions

[SOP] Labeling of Laboratory Specimens

[SOP] Droplet Precautions

[Policy] Submission of Surgical Specimens to Pathology

[SOP] Infection Prevention Interventions to Prevent Transmission of COVID-19 Infection

[VUMC2Go Tip Sheet] Electronic Ordering of Labs

Vanderbilt Medical Laboratories Test Directory

[VUMC2Go Tip Sheet] Collecting a Blood Bank Specimen - HR/PACU and Procedural Areas

[Policy] Blood Product Administration

[SOP] Blood Products: Non-emergent, Massive Transfusion Protocol (MTP), and Isolation

[VUMC2Go Tip Sheet] Administering Blood: The Guide

[Policy] Isolation Precaution Procedures for Operating Room Patients

[Policy] Isolation – Infection Control Precautions to Prevent Transmission of Contagious Infections

[SOP] Isolation Room Cleaning

Class III: Contaminated

Open, fresh wounds less than 4 hours old, acute non-purulent inflammation of tissue, surgical procedures with major breaks in sterile technique) Penetrating wounds (gun shot wounds), bile spillage during cholecystectomy, diverticulitis, compound fractures, appendectomy for inflamed appendicitis

References

[SOP] Patient Identification (Periop)

[SOP] Airborne Precautions

[SOP] Handling of Surgical Specimens

[SOP] Contact Precautions

[SOP] Labeling of Laboratory Specimens

[SOP] Droplet Precautions

[Policy] Submission of Surgical Specimens to Pathology

[SOP] Infection Prevention Interventions to Prevent Transmission of COVID-19 Infection

[VUMC2Go Tip Sheet] Electronic Ordering of Labs

Vanderbilt Medical Laboratories Test Directory

[VUMC2Go Tip Sheet] Collecting a Blood Bank Specimen - HR/PACU and Procedural Areas

[Policy] Blood Product Administration

[SOP] Blood Products: Non-emergent, Massive Transfusion Protocol (MTP), and Isolation

[VUMC2Go Tip Sheet] Administering Blood: The Guide

[Policy] Isolation Precaution Procedures for Operating Room Patients

[Policy] Isolation – Infection Control Precautions to Prevent Transmission of Contagious Infections

[SOP] Isolation Room Cleaning

References

[SOP] Patient Identification (Periop)

[SOP] Airborne Precautions

[SOP] Handling of Surgical Specimens

[SOP] Contact Precautions

[SOP] Labeling of Laboratory Specimens

[SOP] Droplet Precautions

[Policy] Submission of Surgical Specimens to Pathology

[SOP] Infection Prevention Interventions to Prevent Transmission of COVID-19 Infection

[VUMC2Go Tip Sheet] Electronic Ordering of Labs

Vanderbilt Medical Laboratories Test Directory

[VUMC2Go Tip Sheet] Collecting a Blood Bank Specimen - HR/PACU and Procedural Areas

[Policy] Blood Product Administration

[SOP] Blood Products: Non-emergent, Massive Transfusion Protocol (MTP), and Isolation

[VUMC2Go Tip Sheet] Administering Blood: The Guide

[Policy] Isolation Precaution Procedures for Operating Room Patients

[Policy] Isolation – Infection Control Precautions to Prevent Transmission of Contagious Infections

[SOP] Isolation Room Cleaning

References

[SOP] Patient Identification (Periop)

[SOP] Airborne Precautions

[SOP] Handling of Surgical Specimens

[SOP] Contact Precautions

[SOP] Labeling of Laboratory Specimens

[SOP] Droplet Precautions

[Policy] Submission of Surgical Specimens to Pathology

[SOP] Infection Prevention Interventions to Prevent Transmission of COVID-19 Infection

[VUMC2Go Tip Sheet] Electronic Ordering of Labs

Vanderbilt Medical Laboratories Test Directory

[VUMC2Go Tip Sheet] Collecting a Blood Bank Specimen - HR/PACU and Procedural Areas

[Policy] Blood Product Administration

[SOP] Blood Products: Non-emergent, Massive Transfusion Protocol (MTP), and Isolation

[VUMC2Go Tip Sheet] Administering Blood: The Guide

[Policy] Isolation Precaution Procedures for Operating Room Patients

[Policy] Isolation – Infection Control Precautions to Prevent Transmission of Contagious Infections

[SOP] Isolation Room Cleaning

References

[SOP] Patient Identification (Periop)

[SOP] Airborne Precautions

[SOP] Handling of Surgical Specimens

[SOP] Contact Precautions

[SOP] Labeling of Laboratory Specimens

[SOP] Droplet Precautions

[Policy] Submission of Surgical Specimens to Pathology

[SOP] Infection Prevention Interventions to Prevent Transmission of COVID-19 Infection

[VUMC2Go Tip Sheet] Electronic Ordering of Labs

Vanderbilt Medical Laboratories Test Directory

[VUMC2Go Tip Sheet] Collecting a Blood Bank Specimen - HR/PACU and Procedural Areas

[Policy] Blood Product Administration

[SOP] Blood Products: Non-emergent, Massive Transfusion Protocol (MTP), and Isolation

[VUMC2Go Tip Sheet] Administering Blood: The Guide

[Policy] Isolation Precaution Procedures for Operating Room Patients

[Policy] Isolation – Infection Control Precautions to Prevent Transmission of Contagious Infections

[SOP] Isolation Room Cleaning

Anatomic Pathology

Blood Order Verification in Epic

Class IV: Dirty/Infected

Open wound greater than 4 hours old, old traumatic wounds with retained devitalized tissue, existing clinical infection, perforated viscera I&D of abscess, delayed primary closure of wound after ruptured appendix, positive pre-op blood cultures, perforated bowel, peritonitis, wound debridement

References

[SOP] Patient Identification (Periop)

[SOP] Airborne Precautions

[SOP] Handling of Surgical Specimens

[SOP] Contact Precautions

[SOP] Labeling of Laboratory Specimens

[SOP] Droplet Precautions

[Policy] Submission of Surgical Specimens to Pathology

[SOP] Infection Prevention Interventions to Prevent Transmission of COVID-19 Infection

[VUMC2Go Tip Sheet] Electronic Ordering of Labs

Vanderbilt Medical Laboratories Test Directory

[VUMC2Go Tip Sheet] Collecting a Blood Bank Specimen - HR/PACU and Procedural Areas

[Policy] Blood Product Administration

[SOP] Blood Products: Non-emergent, Massive Transfusion Protocol (MTP), and Isolation

[VUMC2Go Tip Sheet] Administering Blood: The Guide

[Policy] Isolation Precaution Procedures for Operating Room Patients

[Policy] Isolation – Infection Control Precautions to Prevent Transmission of Contagious Infections

[SOP] Isolation Room Cleaning

References

[SOP] Patient Identification (Periop)

[SOP] Airborne Precautions

[SOP] Handling of Surgical Specimens

[SOP] Contact Precautions

[SOP] Labeling of Laboratory Specimens

[SOP] Droplet Precautions

[Policy] Submission of Surgical Specimens to Pathology

[SOP] Infection Prevention Interventions to Prevent Transmission of COVID-19 Infection

[VUMC2Go Tip Sheet] Electronic Ordering of Labs

Vanderbilt Medical Laboratories Test Directory

[VUMC2Go Tip Sheet] Collecting a Blood Bank Specimen - HR/PACU and Procedural Areas

[Policy] Blood Product Administration

[SOP] Blood Products: Non-emergent, Massive Transfusion Protocol (MTP), and Isolation

[VUMC2Go Tip Sheet] Administering Blood: The Guide

[Policy] Isolation Precaution Procedures for Operating Room Patients

[Policy] Isolation – Infection Control Precautions to Prevent Transmission of Contagious Infections

[SOP] Isolation Room Cleaning

Class I: Clean

Uninfected, no inflammation, did not enter a tract*, and closed primarilyMost cardiac and neuro cases, closed ortho cases, mastectomy, hernia, vascular, exploratory laparotomy, non-penetrating trauma, thyroidectomy/neck dissection

Anatomic Pathology Lab

Circulator!

Orders Needing Specimen Collection

Inaccessible Armband

Positive patient identification (PPID) should be performed per hospital policy, however, there are times when a patient’s armband is inaccessible

1. Follow the identified collection workflow utilizing the Labs/Test tab
2. After completing the Print Label link, click the Collect link (this will open a category list with options)
3. Select Inaccessible – OR/Procedure Rooms Only from the list

1. Click Override
2. Complete the collection process (scan the specimen lab-ready label)
3. Click Accept