Unlabeled/Mislabeled POC

I would also like to see examples.  Did you receive any responses to this inquiry?

For our point of care we treat mislabeled/unlabeled specimens in the manner that our laboratory does. Must have a recollection and test be repeated. A risk report is submitted by me if anything is seen or reported to me! But I would like to know what others are doing as well. 

     We also treat unlabeled/mislabeled samples under our laboratory policy. The policy outlines different scenarios depending on the source of the sample (ie blood vs a body fluid or tissue). In the point of care setting at our facility, anything unlabeled would have to be recollected. We do have a label discrepancy form, but we typically use it for lab specimens, not POC.
     We also recommend that if there is ever an instance where a patient's armband cannot be scanned, never to type a medical record or account number that could be accidently entered incorrectly. Instead, we have our operators type in the patient's name. This allows us to review and confirm the patient ID in our middleware before uploading into the EMR. Hope this helps!

How about the scenario where point of care testing is performed during a code or critical care situation?  The results are specific to that date/time (where patient was in crises) and actions were likely taken based upon those results.  If the sample was mislabeled, how is that handled?  A repeat sample would likely not generate the same results.

     Amanda, that is a great question! Do you mind sharing what point of care testing you are referring to in a code scenario? For our facility, if we have a medical response, we are most likely doing a finger stick for a glucose and possibly an EPOC blood gas. Both of these would not require a labeled sample but rather scanning their armband or typing in their name on the bedside device. 
    However, if a sample was mislabeled and the results are important to the date and time, we would have them fill out a labeling discrepancy form that would need to be filled out by the collector. Manager approval could also be indicated here, depending on the policy.

For Point of Care, we consider the scanning/entry of the patient ID to be "sample labeling".  If an emergent ID was used, a Glucometer ID Card (asks for all pertinent data to match to result in middleware) must be submitted within 24 hours for reconciliation If not submitted or a wrong patient ID was entered (wrong facility armband is an issue with multiple facility system ) an RL is generated and the manager/operator notified with review of steps that should have been taken for the appropriate scenario, i.e. if no patient name displays, (1) verify correct facility is displayed on the armband [ADMIT:FAC is on bottom left side of band], and (2) confirm displayed ID matches CSN on armband before overriding the Invalid Patient ID warning.  Trying to remind staff that simply scanning the barcode is not verification of correct patient when the name isn't displayed. There are still issues with scanned armband linear barcodes not reading correctly (% or $ or incorrect numbers) on those analyzers that can only read linear barcodes but have found the QR codes to be cleaner to "read".