Patient identification and tube labelling – a call for harmonisation

Dongen-Lases, Edmée C. van; Cornes, Michael; Grankvist, Kjell; Ibarz, Mercè; Kristensen, Gunn B.B.; Lippi, Giuseppe; Nybo, Mads; Šimundić, Ana-Maria

doi:10.1515/cclm-2015-1089

Cited by 44 publications

(30 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…If the phlebotomist is a member of the laboratory staff, he/she will be aware of the impact of the quality of sampling on the quality of results. If he/she is external to the laboratory, the laboratory must provide all information necessary about good sampling practices [6, 36]. …”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Pre-analytical issues in the haemostasis laboratory: guidance for the clinical laboratories

Magnette¹,

Chatelain²,

Châtelain³

et al. 2016

Thrombosis J

103

112

View full text Add to dashboard Cite

Ensuring quality has become a daily requirement in laboratories. In haemostasis, even more than in other disciplines of biology, quality is determined by a pre-analytical step that encompasses all procedures, starting with the formulation of the medical question, and includes patient preparation, sample collection, handling, transportation, processing, and storage until time of analysis. This step, based on a variety of manual activities, is the most vulnerable part of the total testing process and is a major component of the reliability and validity of results in haemostasis and constitutes the most important source of erroneous or un-interpretable results.Pre-analytical errors may occur throughout the testing process and arise from unsuitable, inappropriate or wrongly handled procedures. Problems may arise during the collection of blood specimens such as misidentification of the sample, use of inadequate devices or needles, incorrect order of draw, prolonged tourniquet placing, unsuccessful attempts to locate the vein, incorrect use of additive tubes, collection of unsuitable samples for quality or quantity, inappropriate mixing of a sample, etc. Some factors can alter the result of a sample constituent after collection during transportation, preparation and storage.Laboratory errors can often have serious adverse consequences. Lack of standardized procedures for sample collection accounts for most of the errors encountered within the total testing process. They can also have clinical consequences as well as a significant impact on patient care, especially those related to specialized tests as these are often considered as “diagnostic”. Controlling pre-analytical variables is critical since this has a direct influence on the quality of results and on their clinical reliability. The accurate standardization of the pre-analytical phase is of pivotal importance for achieving reliable results of coagulation tests and should reduce the side effects of the influence factors. This review is a summary of the most important recommendations regarding the importance of pre-analytical factors for coagulation testing and should be a tool to increase awareness about the importance of pre-analytical factors for coagulation testing.

show abstract

Section: Methodsmentioning

confidence: 99%

“…Some factors can alter the result of a sample constituent after collection during transportation, preparation and storage. The side effects of such factors of influence can be reduced by standardizing the pre-analytical process [4–6]. …”

Section: Introductionmentioning

confidence: 99%

Pre-analytical issues in the haemostasis laboratory: guidance for the clinical laboratories

Magnette¹,

Chatelain²,

Châtelain³

et al. 2016

Thrombosis J

103

112

View full text Add to dashboard Cite

show abstract

“…However, with a continuous blood sampling quality control, misidentification errors should be eliminated by constantly increasing the awareness on the issue. Recently, a harmonisation of the patient identification procedure was suggested by the EFLM WG-PRE in order to prevent patient identity mix-up ( 20 ), so hopefully such harmonized procedures can improve patient safety in the future.…”

Section: Discussionmentioning

confidence: 99%

Continuous quality control of the blood sampling procedure using a structured observation scheme

Seemann

Nybo

2016

Biochem Med

Self Cite

View full text Add to dashboard Cite

IntroductionAn observational study was conducted using a structured observation scheme to assess compliance with the local phlebotomy guideline, to identify necessary focus items, and to investigate whether adherence to the phlebotomy guideline improved.Materials and methodsThe questionnaire from the EFLM Working Group for the Preanalytical Phase was adapted to local procedures. A pilot study of three months duration was conducted. Based on this, corrective actions were implemented and a follow-up study was conducted. All phlebotomists at the Department of Clinical Biochemistry and Pharmacology were observed. Three blood collections by each phlebotomist were observed at each session conducted at the phlebotomy ward and the hospital wards, respectively. Error frequencies were calculated for the phlebotomy ward and the hospital wards and for the two study phases.ResultsA total of 126 blood drawings by 39 phlebotomists were observed in the pilot study, while 84 blood drawings by 34 phlebotomists were observed in the follow-up study. In the pilot study, the three major error items were hand hygiene (42% error), mixing of samples (22%), and order of draw (21%). Minor significant differences were found between the two settings. After focus on the major aspects, the follow-up study showed significant improvement for all three items at both settings (P < 0.01, P < 0.01, and P = 0.01, respectively).ConclusionContinuous quality control of the phlebotomy procedure revealed a number of items not conducted in compliance with the local phlebotomy guideline. It supported significant improvements in the adherence to the recommended phlebotomy procedures and facilitated documentation of the phlebotomy quality.

show abstract

“…The many errors still attributable to inaccurate patient identification and inappropriate labelling of blood tubes are well known to everybody working in clinical laboratories, but are somehow underestimated, or overlooked, by a large proportion of healthcare staff with blood collection responsibilities [21,22]. This evidence persuaded the WG-PRE to develop ad hoc recommendations to help increase the standardization of these two crucial preanalytical steps [23]. Essentially, the WG-PRE currently recommends that (i) zero tolerance should be established by the healthcare institutions for patient identification errors; (ii) no fewer than two (preferably three) unique patient identifiers are needed for accurate patient identification, one of which may be the full name of the patient; (iii) the verification of patient identity with specimen labels should be performed in the presence of the patient; (iv) a set of standard operating procedures for patient and blood tubes identification should be made available by healthcare institutions to the phlebotomy staff; (v) a policy of systematic detection and recording of identification errors should be locally established by each healthcare institution; (vi) supplementary education and training of phlebotomy staff should be planned; (vii) the member societies of the EFLM have a duty to implement and audit compliance with these recommendations at both a national and local level; (viii) these recommendations should be considered by supranational quality and standardization organizations such as the CLSI or the International Organization for Standardization when drafting or revising their documents.…”

Section: Patient and Blood Tubes Identificationmentioning

confidence: 99%

The EFLM strategy for harmonization of the preanalytical phase

Lippi¹,

Šimundić²

2017

Clinical Chemistry and Laboratory Medicine (CCLM)

Self Cite

View full text Add to dashboard Cite

Abstract:The Working Group for the Preanalytical Phase (WG-PRE) was officially established by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) in 2013, with the aim of improving harmonization in the preanalytical phase across European member societies. Since its early birth, the WG-PRE has already completed a number of projects, including harmonizing the definition of fasting status, patient and blood tubes identification, color coding of blood collection tubes, sequence of tubes during blood drawing and participation in the development of suitable preanalytical quality indicators. The WG-PRE has also provided guidance on local validation of blood collection tubes, has performed two European surveys on blood sampling procedures and has organized four European meetings to promote the importance of quality in the preanalytical phase. The future activities entail development and validation of an external quality assessment scheme focused on preanalytical variables, development and dissemination of a survey about the local management of unsuitable samples in clinical laboratories, as well as release of EFLM phlebotomy guidelines. This article summarizes all recent achievements of the WG-PRE and illustrates future projects to promote harmonization in the preanalytical phase.

show abstract

Patient identification and tube labelling – a call for harmonisation

Cited by 44 publications

References 21 publications

Pre-analytical issues in the haemostasis laboratory: guidance for the clinical laboratories

Pre-analytical issues in the haemostasis laboratory: guidance for the clinical laboratories

Continuous quality control of the blood sampling procedure using a structured observation scheme

The EFLM strategy for harmonization of the preanalytical phase

Contact Info

Product

Resources

About