Clinical Specimen Processing
Course Objectives
The purpose of this article is to be able to:
- Explain the importance of accurate specimen identification and labeling in preventing pre-analytical errors.
- Describe proper tube handling techniques, including order of draw and mixing, and how these steps affect specimen integrity.
- Identify special processing requirements for temperature-sensitive, light-sensitive, and time-sensitive specimens.
- Recognize common errors in specimen processing, such as hemolysis, clotting, or delayed transport, and their impact on diagnostic accuracy.
- Apply effective documentation and communication practices to support laboratory efficiency, quality, and patient safety.
Course Content
Course Creator: Kristen Moylan BSPH, CCRC
Total CE Hours: 1 Credit Hour
Pace Course #: 586-2505-25
Course Overview:
Course Overview:
Clinical specimen processing is one of the most important links in the chain of patient care, and phlebotomists play a central role in ensuring that specimens are viable, accurate, and ready for analysis. This course provides a comprehensive overview of the steps involved in handling specimens after collection and the impact each step has on laboratory results. While phlebotomists may not perform the actual testing, their attention to detail during processing is essential to the accuracy of diagnostic outcomes.
Participants will review best practices for specimen identification and labeling, including strategies to prevent misidentification errors. The course will also cover the correct handling of tubes, the importance of the order of draw, and how improper mixing, hemolysis, or clotting can interfere with downstream testing. Special emphasis will be placed on processing requirements for specimens with unique needs, such as those requiring refrigeration, protection from light, or rapid transport to maintain analyte stability.
Learners will also explore the role of documentation and communication in specimen processing. Accurate information provided on requisitions and prompt reporting of compromised specimens help laboratory staff make informed decisions and avoid unnecessary delays in patient care. Case scenarios will demonstrate how small lapses, such as mislabeled tubes or delayed transport, can lead to specimen rejection, repeat collections, or inaccurate results.
By the end of this course, participants will gain a clear understanding of how specimen processing fits into the larger framework of the clinical laboratory. They will be able to recognize potential sources of error, apply strategies to preserve specimen integrity, and appreciate how their role in the pre-analytical phase directly contributes to patient safety, diagnostic accuracy, and overall quality of care.
References:
References:
- Bazzano, G., Galazzi, A., Giusti, G. D., Panigada, M., & Laquintana, D. (2021). The Order of Draw during Blood Collection: A Systematic Literature Review. International Journal of Environmental Research and Public Health, 18(4), 1568. https://doi.org/10.3390/ijerph18041568
- Improve. (2024, June 30). Ensuring Proper Handling and Storage of Blood Specimens: Guidelines for Healthcare Professionals. Improve Medical. https://www.improve-medical.net/resources-31/Ensuring-Proper-Handling-and-Storage-of-Blood-Specimens:-Guidelines-for-Healthcare-Professionals
- Needle Tube. (2023, September 26). Effects Of Light Exposure On Lab Tests: Importance, Impact, and Prevention. Needle.Tube - Diagnostic Lab Supplies, Great Prices, Fast Delivery, Blood Collection Needles, Blood Collection Tubes, Infusion Needles. https://www.needle.tube/resources-9/effects-of-light-exposure-on-lab-tests-importance-impact-and-prevention
- Plebani, M. (2012). Quality Indicators to Detect Pre-Analytical Errors in Laboratory Testing. The Clinical Biochemist Reviews, 33(3), 85. https://pmc.ncbi.nlm.nih.gov/articles/PMC3428256/
- Rare Disease Advisor. (2021, September 9). Cold Agglutinin Disease Testing. Rare Disease Advisor. https://www.rarediseaseadvisor.com/disease-info-pages/cold-agglutinin-disease-testing/
- Srikanth, K. K., & Lotfollahzadeh, S. (2021). Phlebotomy. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK574569/
- Understanding Blood Ammonia Levels: Causes, Symptoms & Diagnosis - The Kingsley Clinic. (2025). The Kingsley Clinic. https://thekingsleyclinic.com/resources/understanding-blood-ammonia-levels-causes-symptoms-diagnosis/
- wan Azman, W. N., Omar, J., Koon, T. S., & Tuan Ismail, T. S. (2019). Hemolyzed Specimens: Major Challenge for Identifying and Rejecting Specimens in Clinical Laboratories. Oman Medical Journal, 34(2), 94–98. https://doi.org/10.5001/omj.2019.19
- Lippi, G., Chance, J. J., Church, S., Dazzi, P., Fontana, R., Giavarina, D., Grankvist, K., Huisman, W., Kouri, T., Palicka, V., Plebani, M., Puro, V., Salvagno, G. L., Sandberg, S., Sikaris, K., Watson, I., Stankovic, A. K., & Simundic, A.-M. (2011). Preanalytical quality improvement: from dream to reality. Clinical Chemistry and Laboratory Medicine, 49(7). https://doi.org/10.1515/cclm.2011.600
- Carraro, P., & Plebani, M. (2007). Errors in a Stat Laboratory: Types and Frequencies 10 Years Later. Clinical Chemistry, 53(7), 1338–1342. https://doi.org/10.1373/clinchem.2007.088344
- Green, S. F. (2013). The cost of poor blood specimen quality and errors in preanalytical processes. Clinical Biochemistry, 46(13-14), 1175–1179. https://doi.org/10.1016/j.clinbiochem.2013.06.001
