Label Printing

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Overview

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How Label Printing Works

1. bLIS checks if the test spec has Print Labels enabled
2. If enabled, a label is queued for printing
3. Labels include:
   • Accession number
   • Patient/subject identifier
   • Test code and name
   • Barcode (if configured)
   • Collection date/time
   • Any custom fields

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Configuring Label Printing

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Per Test Specification

1. Navigate to Administration → Test Specifications
2. Edit the test spec
3. Configure label settings:
   • Print Labels: Enable automatic label printing
   • Print Labels With Reflex: Also print labels for reflexed tests
   • Preferred Tube: Default specimen container type

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Print Labels Flag

• true: Automatically print labels when this test is ordered
• false: No automatic labels (manual printing if needed)

• Tests requiring dedicated specimen collection (e.g., blood cultures)
• Tests with specific tube requirements
• Tests where pre-printed labels reduce errors

• Tests performed on already-collected specimens
• Add-on tests to existing samples
• Tests that share specimens with other tests

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Print Labels With Reflex

• true: Print labels for tests triggered by reflex logic
• false: Don’t print labels for reflexed tests

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Preferred Tube Configuration

• Specifies the default specimen container
• Label can include tube type information
• Helps phlebotomists collect the correct specimen

• CBC → Lavender top (EDTA)
• BMP → Green top (Heparin)
• PT/INR → Light blue top (Citrate)

• Correct anticoagulant for the test
• Proper specimen volume
• Reduced collection errors

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Label Content

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Required Information

• Accession Number: 8-digit unique identifier
• Patient Name/ID: Subject identifier
• Test Code: Short test identifier (e.g., “CBC”, “BMP”)
• Collection Date/Time: When specimen should be collected

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Optional Information

• Barcode: 1D or 2D barcode for scanning
• Tube Type: Preferred specimen container
• Priority: STAT vs routine
• Special Instructions: e.g., “Fasting required”
• Custom Fields: Laboratory-specific information

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Barcode Standards

• Code 128: High-density 1D barcode
• Code 39: Simple 1D barcode
• QR Code: 2D barcode for more data
• Data Matrix: Compact 2D barcode

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Label Printers

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Supported Printers

• Zebra: ZD420, ZD620, ZT411, etc.
• Dymo: LabelWriter series
• Brother: QL series
• Generic: Any printer supporting ZPL or EPL

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Printer Setup

1. Install printer on laboratory network or workstation
2. Configure printer settings in bLIS:
   • Printer name/IP address
   • Label size (e.g., 2” x 1”)
   • Print density
   • Connection type (USB, network, Bluetooth)
3. Test print to verify configuration
4. Assign to workstations where labels are needed

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Network vs Local Printing

• Shared across multiple workstations
• Centralized in specimen collection area
• Requires network configuration
• Better for high-volume labs

• Connected directly to workstation
• Dedicated to specific user/location
• Simpler setup
• Better for distributed collection sites

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Common Workflows

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Standard Order Entry

1. User creates accession
2. Adds test orders
3. For each test with printLabels: true:
   • Label is generated
   • Sent to configured printer
   • User applies label to specimen tube
4. Specimen collected and processed

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Batch Printing

1. Create multiple accessions
2. Queue all labels
3. Print batch at once
4. Sort labels by patient/time
5. Distribute for collection

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Reflex Testing Example

Initial order: Strep Screen (printLabels: true)
→ Label prints for throat swab

Result: Positive
→ Reflex to: Throat Culture (printLabelsWithReflex: true)
→ Additional label prints for culture plate

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Troubleshooting

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Labels Not Printing

• Verify printLabels is set to true
• Confirm printer is configured
• Test printer connectivity

• Printer is online and ready
• Labels loaded correctly
• No paper jams or errors

• Labels may be queued but not sent
• Check for failed print jobs
• Retry printing if needed

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Wrong Label Content

• Template matches laboratory standards
• All required fields included
• Barcode format correct

• Preferred tube matches expectations
• Test code/name are correct
• Custom fields configured properly

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Labels Print for Wrong Tests

• Some tests shouldn’t have printLabels enabled
• Check for accidentally enabled flags
• Disable for add-on or reflexed tests as appropriate

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Barcode Won’t Scan

• Increase print density for darker bars
• Verify barcode symbology (Code 128, etc.)
• Ensure label size is adequate

• Configure scanner for correct symbology
• Test with known-good barcode
• Check for damaged scanner laser

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Best Practices

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Configuration

• Enable label printing only for tests requiring dedicated specimens
• Use printLabelsWithReflex judiciously (only when reflex needs new specimen)
• Link preferred tubes to all tests for guidance
• Test label printing in staging before deploying

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Label Design

• Keep labels concise and readable
• Use high-contrast text (black on white)
• Include patient name and accession number prominently
• Add barcodes in consistent locations
• Follow CAP/CLIA labeling requirements

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Printer Maintenance

• Keep printers clean and free of debris
• Replace thermal print heads periodically
• Use high-quality label stock
• Keep spare printers for backup

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Workflow

• Print labels immediately when orders are created
• Apply labels before specimen collection
• Verify labels match patient before collection
• Re-print if labels are damaged or lost

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Regulatory Considerations

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CLIA Requirements

• Patient identifier (name and/or unique ID)
• Date and time of collection
• Collector’s initials (can be added manually)

• Consistent labeling
• Reduced transcription errors
• Complete information on every label

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CAP Requirements

• Positive patient identification
• Specimen labeling at collection time
• Labels must be permanently affixed

• Ensures consistent compliance
• Provides audit trail of label generation
• Reduces human error in labeling

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Best Practice Standards

• Use two patient identifiers when possible
• Include visual and machine-readable (barcode) identifiers
• Prevent label switching or mix-ups
• Document label printing in LIS

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Advanced Features

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Conditional Label Printing

• Only for STAT orders
• Only during certain hours
• Only for specific organizations
• Based on custom sample fields

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Multi-Label Printing

• Primary specimen tube
• Aliquot tubes
• Slide labels
• Storage labels

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Custom Label Templates

• Add institutional logo
• Include custom fields
• Adjust barcode size/position
• Localize language

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Integration with Instruments

1. Specimen tracking through laboratory workflow
2. Instrument integration (analyzers scan barcodes to identify specimens)
3. Error reduction (eliminate manual entry of accession numbers)
4. Chain of custody documentation

• Results automatically link to correct accession
• Reduces result entry time
• Prevents sample mix-ups
• Provides timestamp of analysis