Measurement of Variation in Videotaped Outpatient Phlebotomies: A Model for Phlebotomy Improvement

Ho, Andrew P.; Purdy, Lisa; Adrian, Bonnie; Higa, Thomas; Cembrowski, George S.

doi:10.1309/ljut-k8c6-l9wx-e00p

Cited by 6 publications

(5 citation statements)

References 2 publications

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“…The findings also need to be set in the context of growing international evidence for divergence and non-compliance with basic procedures in healthcare such as medication delivery, 8,9 injection safety 10,11 and phlebotomy techniques. 12 The lapses revealed in checking the resuscitation trolley mirror those seen in other basic procedures and reflect the difficulty of maintaining standard routines in a busy healthcare environment.…”

Section: Discussionmentioning

confidence: 96%

Re-stocking the resuscitation trolley: how good is compliance with checking procedures?

Smith¹,

Bailey²,

Aggarwal³

et al. 2008

Clinical Risk

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This study retrospectively reviewed compliance with the checking policy for resuscitation trolleys on medical, surgical and paediatric wards in a large UK city-based teaching hospital. Successful advanced life support (ALS) relies on the availability of a resuscitation trolley that provides the required equipment and recommended drugs. Missing or faulty equipment can significantly compromise ALS. Local policy stipulates periodic checking, and re-stocking as required, of resuscitation trolleys, and checklists are provided for this purpose. The checklist forms located on each trolley were examined between January and December 2005. The frequency of checking was compared with the arrest calls made within that period. The medical, surgical and paediatric wards had a mean checking rate of 72.2%, 68.8% and 65.9%, respectively. In December one ward checked their trolley on 11/31 (35.5%) days of the month, during which there were two cardiac arrest calls. In this hospital, basic trolley checking procedures are not being followed, leaving the trolley unchecked, and possibly unprepared, for an emergency cardiopulmonary arrest. Hospitals should regularly review compliance with policies and procedures for the checking of resuscitation equipment to ensure that appropriate and functioning equipment, and unexpired drugs are in place in all clinical areas.

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Section: Discussionmentioning

confidence: 96%

Re-stocking the resuscitation trolley: how good is compliance with checking procedures?

Smith¹,

Bailey²,

Aggarwal³

et al. 2008

Clinical Risk

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show abstract

“…There is a dearth of literature on the effectiveness of training and whether training ensures competent and skilled staff. In a special report (Ho, Purdy, Adrian, Higa, & Cembrowski, 2002), researchers observed trained phlebotomists, with an average of 10 years experience, on their performance of venepuncture and found that out of 38 parameters monitored, they were noncompliant in 13 of them. Not allowing sufficient drying time for the disinfectant was at the top of the noncompliance list followed by repalpation of the puncture site; contamination of the site and not cleaning effectively was also at the top of noncompliance together with wrong needle angle.…”

Section: Introductionmentioning

confidence: 99%

The bloody truth: Investigating nurse phlebotomy competencies at a private laboratory in Johannesburg, South Africa

Crous

Armstrong

2016

Health SA Gesondheid

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Background: With the introduction of the phlebotomist technician-certification programme in South Africa, nurses' phlebotomy competence, an acquired skill during basic training, was questioned. Various studies indicate that the majority of errors occur during the collection phase, causing negative outcomes for the patient. Objective: Despite in-service training, samples were rejected and linked to the nurse phlebotomist's sample collection technique. The purpose of this study was to establish if nurses' phlebotomy techniques could be improved through a workplace-training programme in the attempt to improve the quality of the test results. Method: The methodology used was a quantitative, experimental, pilot intervention study, based on a one group pre-test -post-test design. Data was collected by means of peer video recordings of the nurses (n ¼ 20) based at outpatient departments of the laboratory. Independent evaluators evaluated the recordings against criterion-based observational checklists.Results: Compliance to standards on the venepuncture procedure was identified during the pre-test, with an average score of 61.9%. The training programme, developed to address all deviations from the standards, proved to be effective as the post-test compliance score was 85%. Conclusion:The reason for improving nurses' phlebotomy skills is to ensure accurate results that will assist clinicians caring for their patients. The results suggest that knowledge and skills were acquired, however further investigations are needed for guidance in the standardisation of training programmes and at what intervals should these training programmes be presented.

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“…[2][3][4] Moreover, complications associated with blood collection processes are preventable and are directly linked to the technique performed. 1 Observing phlebotomists while they perform a venipuncture to identify nonconformities' may improve the quality of diagnostic blood specimens, and reduce laboratory variability on pre-analytical phase.…”

Section: Introductionmentioning

confidence: 99%

“…1 Observing phlebotomists while they perform a venipuncture to identify nonconformities' may improve the quality of diagnostic blood specimens, and reduce laboratory variability on pre-analytical phase. [2][3][4] Moreover, complications associated with blood collection processes are preventable and are directly linked to the technique performed. 5 Furthermore, opportunities for errors are created when those health professionals who perform blood collection lack knowledge about laboratory practice or do not have the appropriate skill to perform the necessary procedures.…”

mentioning

confidence: 99%

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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Measurement of Variation in Videotaped Outpatient Phlebotomies: A Model for Phlebotomy Improvement

Cited by 6 publications

References 2 publications

Re-stocking the resuscitation trolley: how good is compliance with checking procedures?

Re-stocking the resuscitation trolley: how good is compliance with checking procedures?

The bloody truth: Investigating nurse phlebotomy competencies at a private laboratory in Johannesburg, South Africa

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

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