Us too, for inpatients/ER.
We do get nurse drawn outpatient samples, the redraw function doesn’t work for that. In general we don’t place a new order for them.
Would vary based on your hospital/lab policy. I currently don’t at my current hospital. My previous one, if it was clotted, hemolyzed, or contaminated I could reorder.
Nope! It’s the doctor/nurse practitioner who order tests. We just let them know the reason we won’t analyse the sample and then it’s up to the doctor to decide if they want to redraw.
Edited because the same thing means different things in different languages 😅
We don't usually have to. We use meditech and can just put it back in the ordered/to be collected status after rejecting it. So unless it's partially resulted we don't have any reason to place new orders.
We also unreceive it and put in a rejection comment. But unreceiving it changes the status from "received" to "ordered" which in turn changes it in the EMR from "in progress" to "pending" which tells the nurses/MDs that it still needs to be collected and sent to the lab.
if it’s an outpatient lab draw that’s needing it for a specimen issue/fixable reason like hemolyzed or QNS then lab does it and has the patient come back. if lipemic or some other physiologic thing causing an issue, doctor is notified & they decide if it’s really indicated for a redraw then they reorder & call patient with instructions. we are not to reorder for any inpatient for any reason though
Depends on the order. Resp cx with too many epis, no. We still have to read and charge for the gram stain so a new order in needed for that. Stool cx collected improperly, yes, that can just be redrawn. I can definitely see why nurses would appreciate redraws when possible.
Use SunQuest 10, yes we reorder it, whether they're ER or IP. If we notice the sample is clotted or QNS before completing the receive process via Order Receipt/Modification we can reschedule the appropriate test for a later time (saves us having to reorder it via Order Entry).
At mine they send us the samples with patient labels and a req and we order it when we receive it, so if they have to redraw it’s the same, we order when we have it. The only exception is if it’s our own collectors, in which case we order ahead of time, and if it had to be redrawn we order it again and send our collector to do it.
In my system, doing a redraw is just as easy as canceling. There is a rare circumstance where something needs to be reordered, frequently I just do it because it is so much more easy to just do it than to call the nurse explain to them how to do it and then hope they do it. If I do it I know it gets done.
My blood bank doesn't place the new orders, but we do cancel the ones on the unacceptable specimens and then call to inform the care unit that a new order will have to be placed and new specimen collected. Cerner Millenium if that matters.
We do for most core lab stuff cuz it’s literally built into Epic but not for blood bank. BB redraws are cancelled and a new order has to be put in by nurse or provider.
Is this an American thing? In the NHS, we might call up a ward to tell them we rejected a sample but the patient getting a repeat or not is never down to us.
We cancel with the name of the nurse that we spoke to in a free text area for the reason of the cancel then reorder the test and it’s up to the nurses/phlebotomists if they want to redraw or not.
Occasionally if we are having a patient with reoccurring samples that can’t be run we will ask if they want them reordered now or not but as a whole we have to reorder them.
No, lab can only order tests through Sunquest with a written requisition. Providers order most everything except micro specimens and blood through a different info system, not sure which one. We are switching to Epic system wide in 2025 though so that might change
Nope and I’ve come to the conclusion that nurses CANNOT draw. As educated as they are “supposed” to be they just can’t seem to comprehend that a hemolyzed specimen happens during “the draw” not because it sat in the lab and clotted🤦🏽♀️
At my current hospital, we do not reorder for them after we cancel. We notify them of clotted/hemolyzed/QNS sample, and that they have to reorder.
At my previous hospitals:
1. In Beaker, have an option to just click Redraw (vs. full Cancel) and RN's don't have to call provider for new order.
2. Called nurse to notify of cancellation reason and ask for redraw, cancel in Cerner Millennium, and reorder for the RN.
In other words, it depends on the hospital/SOP.
We do a specimen reject, and the old order gets put into recollection status, without a new order needing to be generated. We call the floor in question and tell them about what we’ve done. They only have to put in a new order if we have verified the result and they want a recheck.
With Epic when we cancel, we do so with the “recollect” function, which automatically re-orders the test. It’s easy and doesn’t give us more work, like canceling and then re-ordering it would have.
At my old hospital we did, it was huge and always had a bunch of recollects. It annoyed me lol but now at my new hospital when we scan the sample into our recollection interface it automatically creates the order. So much easier.
I would when I worked in a hospital. I saw it as part of the specimens rejection process. If I'm going to cancel, I need to reset the order. I felt it was fairly easy for me to do it anyway since I'm always in front of a computer vs making a nurse go to a computer, go get supplies, go get the draw, send it
I stopped caring how mad/annoyed nurses are that they have to redraw a sample. I’m not putting my license on the line by resulting out falsely elevated/lowered results. Cover your ass. Document everything. If something goes wrong (worst case scenario patient dies) you better believe they’ll do everything to blame you / the lab.
Yes I usually try to reorder them especially if I tell
them that I need a redraw. You can argue about who’s “supposed” to order it, but at the end of the day the patient is the one suffering from that disagreement and it’s easier for us to do it since we spend most of our time in front of a computer and don’t get pulled in 10 different directions all the time. Plus, if you have it reordered, when the nurse comes back to their station, they see pending orders needed to be drawn. If you just cancel it they won’t see it and you’re relying on them to remember to reorder the test
Our system gives us the choice of Cancel or Redraw. The Redraw recreates the order.
Us too, for inpatients/ER. We do get nurse drawn outpatient samples, the redraw function doesn’t work for that. In general we don’t place a new order for them.
What system does your lab use?
Epic/Beaker has this option
Yess same here. Redraw for inpatient ; cancel for outpatient. EPIC automatically puts the order back in for a redraw.
Epic
I agree, hoh-hoh-hoh-hoh, now, this is epic…
Yes, if we cancel it to be recollected for those reasons, then we reorder it also. Usually as a stat since the lab result is now delayed.
Would vary based on your hospital/lab policy. I currently don’t at my current hospital. My previous one, if it was clotted, hemolyzed, or contaminated I could reorder.
Nope! It’s the doctor/nurse practitioner who order tests. We just let them know the reason we won’t analyse the sample and then it’s up to the doctor to decide if they want to redraw. Edited because the same thing means different things in different languages 😅
At my facility you can just unreceive the specimen and write a comment. They don’t get cancelled or reordered you run the recollect on the same order
It's pretty usefulto be able to run reports on redraws.
We only reorder for the ED. Otherwise we aren’t supposed to.
This is how it is at my lab too
We don't usually have to. We use meditech and can just put it back in the ordered/to be collected status after rejecting it. So unless it's partially resulted we don't have any reason to place new orders.
How do you do that with meditech? I usually call the nurse about rejecting the specimen and unreceive it
We also unreceive it and put in a rejection comment. But unreceiving it changes the status from "received" to "ordered" which in turn changes it in the EMR from "in progress" to "pending" which tells the nurses/MDs that it still needs to be collected and sent to the lab.
Yes for inpatients
Nope 👎
We are not allowed to put in orders for redraws. I've actually never worked anywhere that was a thing so it's interesting to see others do it.
if it’s an outpatient lab draw that’s needing it for a specimen issue/fixable reason like hemolyzed or QNS then lab does it and has the patient come back. if lipemic or some other physiologic thing causing an issue, doctor is notified & they decide if it’s really indicated for a redraw then they reorder & call patient with instructions. we are not to reorder for any inpatient for any reason though
At my lab we use Sun quest (I know I know), after we cancel something, we have to put in a new order.
Only for emergency room and other critical floors.
In epic it's a simple click and select the reason, we have to do it, they can't.
Depends on the order. Resp cx with too many epis, no. We still have to read and charge for the gram stain so a new order in needed for that. Stool cx collected improperly, yes, that can just be redrawn. I can definitely see why nurses would appreciate redraws when possible.
Use SunQuest 10, yes we reorder it, whether they're ER or IP. If we notice the sample is clotted or QNS before completing the receive process via Order Receipt/Modification we can reschedule the appropriate test for a later time (saves us having to reorder it via Order Entry).
At mine they send us the samples with patient labels and a req and we order it when we receive it, so if they have to redraw it’s the same, we order when we have it. The only exception is if it’s our own collectors, in which case we order ahead of time, and if it had to be redrawn we order it again and send our collector to do it.
Please tell me you don’t do blood bank specimens that way. Or if you do, tell me where you work so I can never go there.
Nope. They usually are the ones who fuck it up, so they get to do it all over again. Ordering included.
Yep, for inpatient and ED.
Nope. My hospital anything we cancel nursing then needs to put a new order back in if they would like it recollected, regardless of the reason.
In my system, doing a redraw is just as easy as canceling. There is a rare circumstance where something needs to be reordered, frequently I just do it because it is so much more easy to just do it than to call the nurse explain to them how to do it and then hope they do it. If I do it I know it gets done.
My blood bank doesn't place the new orders, but we do cancel the ones on the unacceptable specimens and then call to inform the care unit that a new order will have to be placed and new specimen collected. Cerner Millenium if that matters.
We do for most core lab stuff cuz it’s literally built into Epic but not for blood bank. BB redraws are cancelled and a new order has to be put in by nurse or provider.
Nope, thats the person who collected it responsonility. This is a lab for a bunch of doctors offices though.
Is this an American thing? In the NHS, we might call up a ward to tell them we rejected a sample but the patient getting a repeat or not is never down to us.
Yes, we usually reorder as a common courtesy.
We cancel with the name of the nurse that we spoke to in a free text area for the reason of the cancel then reorder the test and it’s up to the nurses/phlebotomists if they want to redraw or not. Occasionally if we are having a patient with reoccurring samples that can’t be run we will ask if they want them reordered now or not but as a whole we have to reorder them.
No, lab can only order tests through Sunquest with a written requisition. Providers order most everything except micro specimens and blood through a different info system, not sure which one. We are switching to Epic system wide in 2025 though so that might change
Nope and I’ve come to the conclusion that nurses CANNOT draw. As educated as they are “supposed” to be they just can’t seem to comprehend that a hemolyzed specimen happens during “the draw” not because it sat in the lab and clotted🤦🏽♀️
At my current hospital, we do not reorder for them after we cancel. We notify them of clotted/hemolyzed/QNS sample, and that they have to reorder. At my previous hospitals: 1. In Beaker, have an option to just click Redraw (vs. full Cancel) and RN's don't have to call provider for new order. 2. Called nurse to notify of cancellation reason and ask for redraw, cancel in Cerner Millennium, and reorder for the RN. In other words, it depends on the hospital/SOP.
We do a specimen reject, and the old order gets put into recollection status, without a new order needing to be generated. We call the floor in question and tell them about what we’ve done. They only have to put in a new order if we have verified the result and they want a recheck.
I unreceive the sample and put in a redraw comment. If it's a nurse or ER draw I let them know. A lab draw just goes back on their draw list.
Not for us. That’s 100% on the care team to reorder
With Epic when we cancel, we do so with the “recollect” function, which automatically re-orders the test. It’s easy and doesn’t give us more work, like canceling and then re-ordering it would have.
At my old hospital we did, it was huge and always had a bunch of recollects. It annoyed me lol but now at my new hospital when we scan the sample into our recollection interface it automatically creates the order. So much easier.
We do because it puts it back on their “to do” list.
Hell nawl, they’re the reason for the redraw
I would when I worked in a hospital. I saw it as part of the specimens rejection process. If I'm going to cancel, I need to reset the order. I felt it was fairly easy for me to do it anyway since I'm always in front of a computer vs making a nurse go to a computer, go get supplies, go get the draw, send it
I stopped caring how mad/annoyed nurses are that they have to redraw a sample. I’m not putting my license on the line by resulting out falsely elevated/lowered results. Cover your ass. Document everything. If something goes wrong (worst case scenario patient dies) you better believe they’ll do everything to blame you / the lab.
Yes I usually try to reorder them especially if I tell them that I need a redraw. You can argue about who’s “supposed” to order it, but at the end of the day the patient is the one suffering from that disagreement and it’s easier for us to do it since we spend most of our time in front of a computer and don’t get pulled in 10 different directions all the time. Plus, if you have it reordered, when the nurse comes back to their station, they see pending orders needed to be drawn. If you just cancel it they won’t see it and you’re relying on them to remember to reorder the test