Checklist template

Specimen collection and laboratory handling for clinics

A ready-to-use checklist with 120 items in 6 sections, covering Collection area, Labelling, Storage, Transport, Requisitions, Results follow-up. Use it as-is in Bindy, or adapt it to your own standards in minutes.

  • 6 Sections
  • 120 Items
  • 102 Yes / No checks
  • 6 Scored ratings
  • 132 Points

Use this template How audits work

1. Collection area 21 items

  1. The blood draw chair has armrests on both sides Yes / No 1 pt
  2. The blood draw chair has a locking arm or bar that keeps a fainting patient from falling forward Yes / No 1 pt
  3. A reclining chair or exam table is nearby for patients who feel faint Yes / No 1 pt
  4. The draw station is screened from the waiting room and the hallway Yes / No 1 pt
  5. The order-of-draw chart is posted at the draw station Yes / No 1 pt
  6. Collection tubes at the station are sorted by cap color Yes / No 1 pt
  7. No expired tube was found among 10 tubes sampled at the station Yes / No 1 pt
  8. Needles and winged collection sets at the station have safety devices Yes / No 1 pt
  9. A sharps container is within arm's reach of the draw chair Yes / No 1 pt
  10. Tourniquets are single-use or wiped between patients Yes / No 1 pt
  11. Gloves are at the station in more than one size Yes / No 1 pt
  12. Alcohol hand rub is within reach of the collector Yes / No 1 pt
  13. The collector observed cleaned their hands before putting on gloves Yes / No 1 pt
  14. The armrest was wiped with disinfectant between the patients observed Yes / No 1 pt
  15. Urine collection instructions are posted in the patient restroom Yes / No 1 pt
  16. Cleansing towelettes for clean-catch urine samples are stocked in the restroom Yes / No 1 pt
  17. The restroom has a pass-through door or a marked shelf for urine cups Yes / No 1 pt
  18. A spill kit is kept in or beside the collection area Yes / No 1 pt
  19. The centrifuge lid locks before the rotor spins Yes / No 1 pt
  20. The centrifuge was loaded with tubes balanced opposite each other Yes / No 1 pt
  21. Set-up of the collection area Rating
    • Fully equipped, clean and private 5 pts
    • Equipped with minor gaps 3 pts
    • Missing safety items or exposed to public view 1 pt

2. Labelling 21 items

  1. Collections observed during the visit Number
  2. The collector asked each patient to state their full name and date of birth Yes / No 1 pt
  3. The collector compared the patient's stated identity with the label or requisition before collecting Yes / No 1 pt
  4. Tubes were labeled after the draw, not before Yes / No 1 pt
  5. Tubes were labeled before the collector left the patient's side Yes / No 1 pt
  6. Only one patient's labels and tubes were at the station at a time Yes / No 1 pt
  7. Each label shows two patient identifiers Yes / No 1 pt
  8. Each label shows the collection date Yes / No 1 pt
  9. Each label shows the collection time Yes / No 1 pt
  10. Each label shows the collector's initials or user code Yes / No 1 pt
  11. Labels are placed on the container, not on the lid Yes / No 1 pt
  12. The label is placed lengthwise so the barcode can be scanned Yes / No 1 pt
  13. The label leaves a window for the laboratory to see the fill level Yes / No 1 pt
  14. Swab and tissue containers are labeled with the body site or source Yes / No 1 pt
  15. Urine cups are labeled by staff after the patient hands them over, with identity confirmed Yes / No 1 pt
  16. Handwritten labels are legible and in permanent ink Yes / No 1 pt
  17. No unlabeled specimen was found at the station, in the refrigerator or in the lockbox Yes / No 1 pt
  18. Unused printed labels of a previous patient are shredded, not left at the station Yes / No 1 pt
  19. Mislabeled or unlabeled specimens reported by the laboratory are recorded as incidents Yes / No 1 pt
  20. Specimens rejected by the laboratory for labeling errors in the last 3 months Number
  21. Labeling of specimens observed Rating
    • Labeled at the patient's side with full details every time 5 pts
    • Labeled correctly but away from the patient 3 pts
    • Pre-labeled, incomplete or unlabeled specimens seen 1 pt

3. Storage 19 items

  1. Specimens are held in a refrigerator used only for specimens Yes / No 1 pt
  2. The specimen refrigerator carries a biohazard label Yes / No 1 pt
  3. No medications, vaccines or food are in the specimen refrigerator Yes / No 1 pt
  4. The specimen refrigerator reads between 36°F and 46°F (2°C and 8°C) Yes / No 1 pt
  5. The specimen refrigerator temperature is recorded each clinic day Yes / No 1 pt
  6. Specimens to be kept at room temperature, refrigerated and frozen are in separately marked racks or bins Yes / No 1 pt
  7. The laboratory's chart of storage temperature by test is posted at the processing area Yes / No 1 pt
  8. Serum tubes are left to clot for the time on the laboratory's instructions before spinning Yes / No 1 pt
  9. Tubes requiring centrifugation were spun within the time on the laboratory's instructions Yes / No 1 pt
  10. Tubes are stored upright in racks Yes / No 1 pt
  11. Each specimen is sealed in its transport bag before it goes into storage Yes / No 1 pt
  12. Tissue containers hold enough fixative to cover the specimen Yes / No 1 pt
  13. Lids on tissue and urine containers were found tight Yes / No 1 pt
  14. Urine that is not tested within the time on the laboratory's instructions is refrigerated Yes / No 1 pt
  15. Specimens waiting for pick-up are out of sight and reach of patients Yes / No 1 pt
  16. No specimen in storage was collected more than one business day ago, unless the test allows it Yes / No 1 pt
  17. The interior of the specimen refrigerator is clean, with no leaked fluid Yes / No 1 pt
  18. Specimen refrigerator temperature at the time of the visit (°F or °C) Number
  19. Storage of specimens before pick-up Rating
    • Correct temperature, sorted and sealed 5 pts
    • Correct temperature, sorting or sealing gaps 3 pts
    • Wrong temperature or specimens left out 1 pt

4. Transport 19 items

  1. No bag waiting for the courier or in the lockbox showed leaked fluid Yes / No 1 pt
  2. The requisition is in the outer pouch of the bag, apart from the container Yes / No 1 pt
  3. Specimens are carried within the clinic in a closed, rigid, leak-proof container Yes / No 1 pt
  4. The courier pick-up times are posted at the processing area Yes / No 1 pt
  5. The last blood draw of the day is scheduled before the final courier pick-up Yes / No 1 pt
  6. The employee asked could say what happens to a specimen collected after the last pick-up Yes / No 1 pt
  7. Each pick-up is recorded with the time and the number of specimens handed over Yes / No 1 pt
  8. The courier signs or scans for the specimens taken Yes / No 1 pt
  9. The pick-up log matched the specimens sent, for 2 days checked Yes / No 1 pt
  10. The lockbox for after-hours pick-up was found locked Yes / No 1 pt
  11. The lockbox is out of direct sun and protected from freezing Yes / No 1 pt
  12. Cold packs are placed in the lockbox in hot weather, per the laboratory's instructions Yes / No 1 pt
  13. No patient names are visible from outside the lockbox Yes / No 1 pt
  14. Frozen specimens are handed to the courier frozen, on the packs or dry ice the laboratory supplies Yes / No 1 pt
  15. Urgent specimens are flagged for the courier with the laboratory's urgent label Yes / No 1 pt
  16. Each missed courier pick-up in the last 3 months was followed up with the laboratory the same day Yes / No 1 pt
  17. Missed or late courier pick-ups in the last 3 months Number
  18. Time of the last courier pick-up on clinic days Short text
  19. Hand-over of specimens for transport Rating
    • Packaged, logged and picked up on schedule 5 pts
    • Picked up on schedule, log incomplete 3 pts
    • Pick-ups missed or specimens sent unlogged 1 pt

5. Requisitions 19 items

  1. Requisitions sampled during the visit Number
  2. Each requisition sampled shows the patient's full name and date of birth Yes / No 1 pt
  3. Each requisition sampled shows the ordering provider Yes / No 1 pt
  4. Each requisition sampled shows the tests ordered, with no handwritten additions lacking an order Yes / No 1 pt
  5. Each requisition sampled shows a diagnosis code for the tests ordered Yes / No 1 pt
  6. Each requisition sampled shows the collection date Yes / No 1 pt
  7. Each requisition sampled shows the collection time Yes / No 1 pt
  8. The fasting status is recorded where the test calls for it Yes / No 1 pt
  9. The patient's insurance details are on the requisition or sent electronically with the order Yes / No 1 pt
  10. The identifiers on the requisition matched the container label in every specimen sampled Yes / No 1 pt
  11. Orders are sent to the laboratory electronically where the interface exists Yes / No 1 pt
  12. The specimen is sent to the laboratory contracted with the patient's insurance plan Yes / No 1 pt
  13. The laboratory's test directory is available at the collection station Yes / No 1 pt
  14. The collector checked the tube type and the volume required before drawing an unfamiliar test Yes / No 1 pt
  15. Standing orders used for repeat tests are within their validity date Yes / No 1 pt
  16. Tests added after collection are requested through the laboratory's add-on process Yes / No 1 pt
  17. A copy or electronic record of each requisition stays at the clinic Yes / No 1 pt
  18. Requisitions sampled with missing or incorrect information Number
  19. Completeness of requisitions sampled Rating
    • Complete in every requisition 5 pts
    • One or two with gaps 3 pts
    • Gaps in most requisitions 1 pt

6. Results follow-up 21 items

  1. A log or system report lists every specimen sent with the date it was sent Yes / No 1 pt
  2. The list of specimens sent is compared with results received at least weekly Yes / No 1 pt
  3. Results still outstanding past the laboratory's turnaround time are chased with the laboratory Yes / No 1 pt
  4. Tissue specimens are tracked individually until the pathology report is received Yes / No 1 pt
  5. Results arrive in the ordering provider's inbox in the electronic record Yes / No 1 pt
  6. Results for an absent provider are redirected to a covering provider Yes / No 1 pt
  7. Providers sign off results within the time set by company policy Yes / No 1 pt
  8. The procedure for critical results from the laboratory is posted at the phones Yes / No 1 pt
  9. The employee taking a critical result by phone reads it back to the caller Yes / No 1 pt
  10. Critical results are recorded with the time received and the provider informed Yes / No 1 pt
  11. Patients are notified of every result, including normal results Yes / No 1 pt
  12. Notification of an abnormal result is documented in the patient record, in 3 records sampled Yes / No 1 pt
  13. Patients whose specimen was rejected are called back for a new collection Yes / No 1 pt
  14. Recollections are recorded with the reason for rejection Yes / No 1 pt
  15. Rejection reasons are reviewed with the collectors Yes / No 1 pt
  16. Results outstanding beyond the laboratory's turnaround time at the time of the visit Number
  17. Results waiting for provider sign-off longer than the time set by company policy Number
  18. Specimens rejected by the laboratory in the last 3 months Number
  19. Name of the employee responsible for specimen handling Short text
  20. Overall control of specimen handling, from collection to result Rating
    • Identified, labeled, stored and tracked to a result every time 5 pts
    • Sound collection with gaps in logs or follow-up 3 pts
    • Labeling, storage or tracking failures seen 1 pt
  21. Corrective actions required Comments

About this template

This checklist is part of the Bindy template library. Yes / No checks score 1 point when met; ratings score the points shown for each option. The overall score is the percentage of points earned, with N/A answers excluded. In Bindy you can add photos, assign corrective actions, require sign-off and compare results across sites.

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