The
mistake:
Relying on what the patient says, or glancing at a label, and assuming it’s
correct—especially when it’s “busy,” or the patient is familiar.
Why it’s
serious:
Wrong patient = wrong result for the wrong person. This is one of the
most dangerous pre-analytical errors and a big red flag in any ISO
15189–aligned lab or accredited facility.
How to
avoid it:
- Always follow your organization’s
two-identifier rule (e.g., full name + date of birth, or medical
record number).
- Match the identifiers on:
- The requisition
- The patient's wristband or
official ID
- The labels you will use
on tubes
- Never let anyone rush you out of
proper identification—not the patient, not a colleague, not the clock.
Good
phlebotomists are polite but firm: “For your safety, I need to verify
your identity with two identifiers.”
The
mistake:
Drawing tubes in a random order, or not respecting the recommended order of
draw.
Why it’s
serious:
The wrong order can cause additive carryover from one tube to another
(e.g., anticoagulants contaminating the next sample), altering lab results and leading to incorrect interpretations.
How to
avoid it:
- Memorize and practice the correct
order of draw (according to your lab/region’s guidelines).
- Use visual aids, charts, or
pocket cards until it becomes automatic.
- Remember: order of draw is part
of quality and accreditation requirements—inspectors and quality
officers care about it.
At MedLabTech
Academy, we emphasize order of draw as a core competency, not just a
detail.
The
mistake:
Labelling tubes later “at the desk” or away from the patient, or using
incomplete/inaccurate labels.
Why it’s
serious:
- Mislabelled or unlabelled tubes
can lead to specimen rejection, delays, or—worse—results being
attributed to the wrong patient.
- From an accreditation standpoint
(e.g., ISO 15189, CPTG expectations), bedside/chair labelling is a non-negotiable
quality requirement.
How to
avoid it:
- Label tubes immediately after
collection, in the presence of the patient.
- Include all required identifiers
(as per your lab policy: name, DOB, ID number, date/time of collection,
collector’s initials, etc.).
- Double-check labels before you
leave the patient.
If you can
make one habit perfect as a new phlebotomist, let it be labelling correctly,
every single time.
The
mistake:
Forgetting to gently invert tubes with additives, or shaking them too hard.
Why it’s
serious:
- Under-mixing: clots may form in
tubes requiring anticoagulants → invalid results or recollection issues.
- Over-shaking: can cause hemolysis
(ruptured red blood cells) → altered lab values (e.g., potassium, LDH).
How to
avoid it:
- Know the correct number of
gentle inversions for each tube type (e.g., 5–10 times, depending on the manufacturer and guidelines).
- Never vigorously shake
tubes. Use gentle inversion, end-over-end.
- Make mixing part of your automatic
routine after each draw.
Accredited
labs pay close attention to hemolysis rates and pre-analytical quality
indicators—your mixing technique has a direct impact.
The
mistake:
Not checking whether the patient followed test instructions (fasting,
medications, posture) or clearly explaining the procedure.
Why it’s
serious:
- If a “fasting” patient has just
eaten or has taken medication that interferes with testing, the result
may be misleading.
- Poor communication increases anxiety,
makes the procedure harder, and harms trust in the healthcare system.
How to
avoid it:
- Always check preparation
requirements for sensitive tests (e.g., fasting glucose, lipids,
GTT).
- Ask simple, clear questions:
“Have you eaten or had anything to drink other than water in the last 8–12
hours?”
- Explain what you’re doing and
why:
- “I’ll place a tourniquet, clean
your arm with alcohol, and you’ll feel a quick pinch.”
- Use calm, respectful language;
treat every patient as you would a family member.
Soft skills
are not “extra”—they are part of pre-analytical quality and patient
safety.
The
mistake:
Leaving blood on the tray for too long, exposing samples to heat or direct
sunlight, or failing to respect time/temperature requirements.
Why it’s
serious:
- Certain analytes (e.g., lactate,
ammonia, blood gases) are extremely time and temperature-sensitive.
- Delays and incorrect storage can
cause false results, specimen rejection, and repeat collections.
How to
avoid it:
- Know which tests need immediate
transport, ice, protection from light, or rapid processing.
- Don’t let completed samples “wait
around” unnecessarily.
- Use dedicated racks/containers
and follow the lab’s transport SOP.
In an ISO
15189-ready lab, pre-analytical transport is part of the validated process.
As a phlebotomist, you are part of that chain.
The
mistake:
Not documenting difficulties (e.g., difficult draw, missed fasting, clotted
samples) or not reporting incidents for fear of blame.
Why it’s
serious:
- Undocumented problems can lead to
misinterpreted results.
- The lab loses valuable quality
data that could be used to improve processes.
- From an accreditation standpoint,
laboratories must show how they monitor and improve pre-analytical
quality, which requires honest reporting.
How to
avoid it:
- If something goes wrong (or
nearly goes wrong), document it according to your lab’s policy (incident
forms, LIS notes, etc.).
- Inform the appropriate person
(supervisor, nurse, or ordering provider) when required.
- See reporting as part of professionalism,
not something to be ashamed of.
Quality-focused
labs—especially those working toward ISO 15189—need phlebotomists who speak
up to improve the system.
In Canada,
organizations like the Canadian Phlebotomy Technicians Group (CPTG) and
accreditation frameworks like ISO 15189 place a strong emphasis on:
- Patient identification
- Pre-analytical quality
- Documentation and professionalism
- Continuous improvement
Avoiding
these 7 mistakes is not just about “being careful”—it’s about aligning your
daily practice with recognized standards and accreditation expectations.
When you can
show that:
- You understand pre-analytical
risks, and
- You’ve completed structured
training in phlebotomy and quality,
You stand out
as a serious, employable, and trusted professional.
At MedLabTech
Academy, our Comprehensive Phlebotomy CPD Certification (In-Person)
Course is designed specifically to build:
- Strong theoretical knowledge
(anatomy, terminology, infection control, quality)
- Reliable practical skills
(venipuncture, order of draw, labelling, mixing, handling)
- Correct pre-analytical habits
aligned with Canadian practice and accreditation expectations
The course
is:
- CPD-accredited
- Delivered by an approved CPTG
training centre
- Structured as a pathway to apply
for the CPTG certification exam (for eligible candidates)
Whether you
are:
- Completely new to phlebotomy, or
- An internationally educated
professional adapting to Canadian standards,
Our training will
help you avoid these common mistakes and build the confidence and
competence you need at the chair and in the lab.If you’re
ready to develop a strong, accreditation-friendly phlebotomy practice—from
patient identification to pre-analytical quality—MedLabTech Academy is here to
support you.
Learn more about our phlebotomy and CPD programs at www.medlabtechacademy.ca
Contact us: info@medlabtechacademy.ca
Better
pre-analytical practice means better results, safer patients, and a stronger
career as a phlebotomist.
