Level of confidence in venepuncture and knowledge in determining causes of blood sample haemolysis among clinical staff and phlebotomists

Makhumula-Nkhoma, Nellie; Whittaker, Victoria; McSherry, Robert

doi:10.1111/jocn.12607

Cited by 15 publications

(12 citation statements)

References 9 publications

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“…Nearly identical results were obtained by Makhumula-Nkhoma et al . in a study that was conducted in the UK on a sample of 290 healthcare professionals ( 17 ). This increase could have a positive impact on reducing the rate of hemolysis of blood samples in clinical laboratories ( 19 ).…”

Section: Discussionmentioning

confidence: 99%

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Confidence level in venipuncture and knowledge on causes of in vitro hemolysis among healthcare professionals

et al. 2015

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IntroductionThis study aimed to assess confidence level of healthcare professionals in venipuncture and their knowledge on the possible causes of in vitro hemolysis.Materials and methodsA sample of 94 healthcare professionals (nurses and laboratory technicians) participated in this survey study. A four-section questionnaire was used as a research instrument comprising general information for research participants, knowledge on possible causes of in vitro hemolysis due to type of material used and venipuncture technique and specimen handling, as well as assessment of healthcare professionals’ confidence level in their own ability to perform first and last venipuncture.ResultsThe average score on the knowledge test was higher in nurses’ than in laboratory technicians (8.11 ± 1.7, and 7.4 ± 1.5, respectively). The difference in average scores was statistically significant (P = 0.035) and Cohen’s d in the range of 0.4 indicates that there is a moderate difference on the knowledge test among the health care workers. Only 11/94 of healthcare professionals recognized that blood sample collection from cannula and evacuated tube is method which contributes most to the occurrence of in vitro hemolysis, whereas most risk factors affecting occurrence of in vitro hemolysis during venipuncture were recognized. There were no significant differences in mean score on the knowledge test in relation to the confidence level in venipuncture (P = 0.551).ConclusionConfidence level at last venipuncture among both profiles of healthcare staff was very high, but they showed insufficient knowledge about possible factors affecting hemolysis due to materials used in venipuncture compared with factors due to venipuncture technique and handling of blood sample.

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Section: Discussionmentioning

confidence: 99%

“…The instrument used for data collection was a questionnaire used by Makhumula-Nkhoma et al . ( 17 ). The questionnaire contains 18 questions and includes sets of questions divided into four sections.…”

Section: Methodsmentioning

confidence: 99%

Confidence level in venipuncture and knowledge on causes of in vitro hemolysis among healthcare professionals

et al. 2015

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“…National societies -There is a national "ambassador" -There is a working group for preanalytical phase in the national society -The recommendation is translated to the local language -Key stakeholders are identified -The implementation is done in collaboration with key stakeholders -Regulatory and governmental bodies support and endorse the implementation activities -All national rules and recommendations take precedence over this document; there is a mechanism to agree on the modifications -Editors of national journals assist by raising awareness patient or themselves which may arise as a consequence of non-adherence to the recommended procedure. By educating staff about potential risks to the patient, caused by poor blood sampling procedure, awareness is raised about the necessity to adhere to the recommended procedure [107][108][109]. Education increases the level of confidence and improves quality of procedures [110].…”

Section: Framework For a Successful Implementation Of This Recommendamentioning

confidence: 99%

Joint EFLM-COLABIOCLI recommendation for venous blood sampling

Šimundić

Bölenius²,

Cadamuro³

et al. 2019

Annales De Biologie Clinique

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Introduction Scope of the guidance Disclaimer Methodology I. Pre-sampling General considerations on appropriate mode of communication with the patient Patient position Step 1. Patient identification (1C) Step 2. Verify patient is fasting and properly prepared (1B) Step 3. Obtain supplies required for venous blood collection (2C) Step 4. Labeling and/or identifying tubes (1C) II. Sampling Step 5. Put on gloves (1C) Step 6. Apply tourniquet (1A) Step 7. Select venepuncture site (1B) Step 8. Clean sampling site (1B) Step 9. Puncture the vein (1A) Step 10. Drawing blood into the first tube (1A) Step 11. Release the tourniquet (1A) Step 12. Gently invert the tubes once immediately after collection (1B) Step 13. Draw additional tubes following the recommended order of draw (1B) Step 14. Remove the needle from the vein and ensure the safety mechanism is activated (1A) Step 15. Dispose of the needle (1A) Step 16. Bandage the puncture site (1C) Step 17. Tell the patient to apply gentle pressure and do not bend the arm (1C) Step 18. Invert all tubes at least 4 more times (1B) Step 19. Remove gloves (1A) III. Post sampling Step 20. Advise the patient to rest for 5 min (1B) IV. Implementation of the guidelines Potential barriers and challenges Framework for a successful implementation of this recommendation Conclusions References

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“…Lillo et al showed that educational programs for nursing personnel dramatically decreased the preanalytical sample errors [18]. Makhumula-Nkhoma et al also published that the importance of continued education and training and monitoring and evaluating the hemolysis rate is crucial [19]. Romero et al stated that they prioritized the potential problems in the preanalytical phase with the use of Healthcare Failure Mode and Effects Analysis (HFMEA), and then to improve their quality, they mainly focused on a specific training program and revision of the existing protocols [15].…”

Section: Discussionmentioning

confidence: 99%

Preanalytical Phase Errors: Experience of a Central Laboratory

Sönmez

Yιldιz

Akkaya

et al. 2020

Cureus

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Introduction: The study intends to observe the frequency of preanalytical phase errors both inside and outside the clinical laboratory according to certain quality indicators (QIs). Methods: The one-week observation focused on 73 nurses drawing blood from 337 patients. It was performed in two stages: the observation of blood collection up to the receipt of the samples, and the receipt of the samples up to the analytical phase. The data pertaining to the number of patients, tests, and rejection rates were obtained from the laboratory information system (LIS) for the one-week and the one-year period and compared with the observational data. Results: The process of blood sample collection from 337 patients taken into 1347 tubes was observed. Although the majority of the nurses (78%) used safety needles, the safety mechanism was properly activated only in 38% of the interventions. Evaluation of biochemistry tubes (n=971) revealed the following: the incorrect fill volume error was 40%; the hemolysis was seen by 17%, and the clotted sample and fibrin were observed by 6%. The incorrect fill volume error was 12% and 20% in ethylenediaminetetraacetic acid (EDTA) and citrated tubes, respectively. Clotted samples and platelet clumps were seen in 1% of EDTA tubes. Conclusion: The study confirms the relative frequency of preanalytical phase error occurring inside and outside of the laboratory.

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Level of confidence in venepuncture and knowledge in determining causes of blood sample haemolysis among clinical staff and phlebotomists

Abstract: Although the hospital is succeeding in providing regular training in venepuncture, this is only one aspect of quality. The process and outcome also need interventions.

Cited by 15 publications

References 9 publications

Confidence level in venipuncture and knowledge on causes of in vitro hemolysis among healthcare professionals

Confidence level in venipuncture and knowledge on causes of in vitro hemolysis among healthcare professionals

Joint EFLM-COLABIOCLI recommendation for venous blood sampling

Preanalytical Phase Errors: Experience of a Central Laboratory

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