Is Phlebotomy Part of the Dark Side in the Clinical Laboratory Struggle for Quality?

Lima-Oliveira, Gabriel; Guidi, Gian Cesare; Salvagno, Gian Luca; Montagnana, Martina; Rego, Fabiane Gomes de Moraes; Lippi, Giuseppe; Picheth, Geraldo

doi:10.1309/lmz7yard6zsdiid

Cited by 26 publications

(44 citation statements)

References 20 publications

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“…According to WHO blood drawing guide line and Bowen et al [10], the puncture site should be clean properly in circular manner from the puncture site out wards slowly but in our study cleaning of collection site was performed by rubbing vigorously and irregularly; sometimes in zig zag and repeating the cleaned site with a dirty swab for 180 (90%) of collections which was almost similar to the study conducted by Lima-Oliveira G et al in Brazil (85%) [4].…”

Section: Discussionsupporting

confidence: 71%

“…Several studies have documented that most of the errors in the clinical laboratory occur in the pre analytical phase accounting up to 80% [2,4,6,8,9]. Phlebotomy is most neglected but regularly practiced medical process worldwide.…”

Section: Discussionmentioning

confidence: 99%

“…Phlebotomy is most neglected but regularly practiced medical process worldwide. It can lead to adverse problems in patient safety and healthy life if not properly regulated [1,2,4,11]. This study aimed to assess the practice of phlebotomists and to identify the major sources of errors during venous blood collection in public hospitals in Addis Ababa, Ethiopia.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical laboratories are now conforming to certification rules of the International Organization for Standardization (ISO) for accreditation programs with standards based on ISO 15189 [4,5]. While the laboratory quality testing process involves three phases: pre-analytical, analytical and post analytical phases'.…”

Section: Introductionmentioning

confidence: 99%

“…A major problem in laboratory quality management is that health care professionals still focus excessive attention on the analytical phase of laboratory testing. Accreditation agencies are increasingly requiring laboratories to go beyond the analytical quality and take responsibility for pre-and postanalytical where most errors arise [3,4,6].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Phlebotomy Services in Clinical Laboratory Setting in Addis Ababa Public Hospitals, Addis Ababa, Ethiopia

Mekonon¹,

Tsegaye²,

Haile³

et al. 2017

AJLM

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Abstract:Background: Phlebotomy is the system of drawing a blood sample for the use of laboratory testing and for blood transfusion. Professionals who are performing phlebotomy services called phlebotomists. It is a critical part of the pre analytical phase of laboratory testing and is the most neglected procedures in health care. About 70% of the quality of the test are affected during phlebotomy and other pre analytical services. However, little is known about the practice of phlebotomy services in developing countries like Ethiopia. Objectives: To assess the practice of phlebotomists and to identify the major sources of errors during venous blood collection in public hospitals in Addis Ababa. Methodology: Hospital based, cross sectional observational and follow-up study was conducted from March to May 30, 2014. The study followed 40 phlebotomists while each of them was collecting 5 different venous blood collections (giving a total of 200 phlebotomies). Well structured questionnaires and checklists were used to collect data. Data was entered on EPI-Data version 3.1 and statistical analysis was performed with SPSS version 20. Descriptive statistics were employed and the Chi square test was used for comparing major errors observed. Result: Almost all laboratory phlebotomy sites had no Standard Oprating Procedures (SOPs) available in collection sites and most of collection sites were not well ventilated. The major errors identified were use of single glove for more than one client 139 of 200 (69.5%), inappropriate cleaning practice of vein puncture sites 180 of 200 (90%), collecting blood before the disinfectant alcohol dried 139 of 200 (69.5%), incorrect tube collection sequences 107 of 200 (53.5%), unnecessarily applying of tourniquets after blood started flowing in to the collection tubes and syringes 170 of 200 (85.0%) and applying tourniquets before locating and selecting appropriate site for venous blood collection 175 of 200 (87.5%). Conclusion and Recommendation: -Many errors were identified in the phlebotomy practice during the observational study. As the quality of blood specimen influences patient result: emphasis should be given on phlebotomy training to improve the practices for phlebotomists and ensure safety as well as quality during blood collections for laboratory analysis.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Evaluation of Phlebotomy Services in Clinical Laboratory Setting in Addis Ababa Public Hospitals, Addis Ababa, Ethiopia

Mekonon¹,

Tsegaye²,

Haile³

et al. 2017

AJLM

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Targeting Rejection: Analysis of Specimen Acceptability and Rejection, and Framework for Identifying Interventions in a Single Tertiary Healthcare Facility

Rooper

Carter

Hargrove

et al. 2016

Clinical Laboratory Analysis

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The impact of fist clenching and its maintenance during venipuncture on routine hematology testing

et al. 2016

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Fist clenching and maintenance during blood collection for routine hematology testing was effective to increase the MCV by 1.2% (P<.001). All others hematological parameters were not significantly biased by fist clenching, though hematocrit, neutrophils, eosinophils, and reticulocytes displayed mindful of trends. We hence advise patients against clenching their fist before blood collection for hematology testing.

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Is Phlebotomy Part of the Dark Side in the Clinical Laboratory Struggle for Quality?

Cited by 26 publications

References 20 publications

Evaluation of Phlebotomy Services in Clinical Laboratory Setting in Addis Ababa Public Hospitals, Addis Ababa, Ethiopia

Evaluation of Phlebotomy Services in Clinical Laboratory Setting in Addis Ababa Public Hospitals, Addis Ababa, Ethiopia

Targeting Rejection: Analysis of Specimen Acceptability and Rejection, and Framework for Identifying Interventions in a Single Tertiary Healthcare Facility

The impact of fist clenching and its maintenance during venipuncture on routine hematology testing

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