Home Health Training
Admin
8.9 Nursing Clinical Skills

Labs, Specimens, and Results Follow-Up

Labelling and transporting specimens, who chases the result, and the handoff that most often fails.

Nursing Updated Sep 18, 2026

Drawing the specimen is the easy part. Most of what goes wrong with labs in home health happens after the needle comes out.

Before you draw

  • Confirm there is a current order for the test
  • Check which lab it is going to — the container depends on it. See Lab Tube Cheat Sheet.
  • Confirm any timing requirement — fasting, or a trough drawn 30 minutes to an hour before the next dose
  • Have the requisition ready and filled in

Labelling

Label at the bedside, in front of the patient, before you leave the room. Never in the car, never later.

Each tube needs: patient name, second identifier (date of birth), date, time of collection, and your initials.

An unlabelled or mislabelled specimen is a rejected specimen, and the patient gets stuck again.

Order of draw

When drawing multiple tubes, follow the standard order to avoid additive carryover:

  1. Blood culture bottles
  2. Sodium citrate (blue)
  3. Serum tubes, with or without gel (red, gold/SST)
  4. Heparin (green)
  5. EDTA (lavender)
  6. Fluoride/oxalate (grey)

Fill each tube to its line, and invert — do not shake — the number of times the manufacturer specifies.

Transport

  • Transport per agency policy and the lab's temperature requirement
  • Keep specimens in a designated container, not loose in the bag
  • Note the time you dropped them — some tests have a stability window measured in hours
  • Never leave specimens in a hot or freezing car between visits

Closing the loop — where it actually fails

This is the part that gets missed, and it is the part that harms patients.

Before you finish the visit, answer three questions in the note:

  1. What did I draw, and when?
  2. Who is expecting the result?
  3. Who is chasing it if it does not arrive?

Then act on it:

  • Result received within the expected window — if not, call the lab
  • Abnormal or critical values reported to the physician the day they arrive
  • Document who you told, what time, and what they said
  • New orders obtained and entered — see Verbal Orders and Clarifications
  • Patient informed, if appropriate
  • Next draw scheduled if the physician wants a recheck

A result nobody looked at is worse than a test nobody ordered. The chart shows you drew it, which means the agency knew — and did nothing.

Where results land

Results are filed under Episode Manager → Miscellaneous, alongside the referral packet and medication reconciliation.

  • Abnormal labs: call the results in to the ordering doctor.
  • All results are faxed to our office and to the ordering doctor
  • The PCP does not always address them promptly, and a follow-up call is appreciated
  • Results are filed under the RN Case Manager's name nine times out of ten — check with them before you call in, in case they have already followed up

Critical values

If a lab calls you with a critical value:

  1. Write it down and read it back
  2. Contact the physician immediately — not at the end of the day
  3. If you cannot reach them, escalate to your Field Supervisor and follow the on-call pathway
  4. Assess the patient; decide whether they are safe at home right now
  5. Document every step with times

Venipuncture and coverage

Worth knowing: venipuncture solely to obtain a blood sample is specifically excluded as a qualifying skilled service. You can draw labs for a patient on service for another skilled reason, but a patient whose only need is a monthly INR draw does not qualify for home health on that basis. See Skilled Need — The Coverage Test.