Effectiveness of Laboratory Practices to Reduce Specimen Labeling Errors at the Time of Specimen Collection in Healthcare Settings: A Laboratory Medicine Best Practices (LMBP) Systematic Review

Abstract

Background: Specimen labeling errors have long plagued the laboratory industry, putting patients at risk of transfusion-related death, medication errors, misdiagnosis, and patient mismanagement. Many interventions have been implemented and deemed to be effective in reducing specimen error rates. The objective of this review was to identify and evaluate the effectiveness of laboratory practices and interventions to develop evidence-based recommendations for the best laboratory practices to reduce labeling errors. Content: The standardized Laboratory Medicine Best Practices InitiativeTM A-6 methods were used to conduct this systematic review. Total evidence included 12 studies published from 1990 to September 2015. Combined data from 7 studies found that the interventions developed from improved communication and collaboration between the laboratory and clinical staff resulted in substantial decreases in specimen labeling errors [median relative percent change in labeling errors: -75.86; interquartile interval (IQI): -84.77, -58.00]. Further data from the subset of 4 studies showed a significant decrease in specimen labeling errors after the institution of the standardized specimen labeling protocols (median relative percent decrease in specimen labeling errors: -72.45; IQI: -83.25, -46.50). Summary: Based on the evidence included in this review, interventions that enhance communication and collaboration between laboratory and healthcare professionals can decrease the number of specimen identification errors in healthcare settings. However, more research is needed to make any conclusion on the effectiveness of other evaluated practices in this review, including training and education of the specimen collection staff, audit and feedback of labeling errors, and implementation of new technology (other than barcoding).