ASSESSMENT OF PREANALYTICAL BLOOD SAMPLING ERRORS IN CLINICAL SETTINGS
Abstract
Background: Blood sampling is one of the common procedures done in every ward for disease diagnosis and prognosis. Daily hundreds of samples are collected from different wards but lack of appropriate knowledge of blood sampling by paramedical staff and accidental errors make the samples inappropriate for testing. Thus the need to avoid these errors for better results still remains. We carried out this research with an aim to determine the common errors during blood sampling; find factors responsible and propose ways to reduce these errors. Methods: A cross sectional descriptive study was carried out at the Military and Combined Military Hospital Rawalpindi during February and March 2014. A Venous Blood Sampling questionnaire (VBSQ) was filled by the staff on voluntary basis in front of the researchers. The staff was briefed on the purpose of the survey before filling the questionnaire. Sample size was 228. Results were analysed using SPSS-21. Results: When asked in the questionnaire, around 61.6% of the paramedical staff stated that they cleaned the vein by moving the alcohol swab from inward to outwards while 20.8% of the staff reported that they felt the vein after disinfection. On contrary to WHO guidelines, 89.6% identified that they had a habit of placing blood in the test tube by holding it in the other hand, which should actually be done after inserting it into the stand. Although 86% thought that they had ample knowledge regarding the blood sampling process but they didn't practice it properly. Conclusion: Pre analytical blood sampling errors are common in our setup. Eighty six percent participants though thought that they had adequate knowledge regarding blood sampling, but most of them were not adhering to standard protocols. There is a need of continued education and refresher courses.
Keywords: paramedical staff, blood sampling, errors, pre-analytical errors
References
Moraglio D, Banfi G. Preanalytical phase in coagulation testing: state of the art in the laboratories of the Piedmont region, Italy. Scand J Clin Lab Invest 1996;56(8):735-42.
Lippi G, Plebani M, Di Somma S, Cervellin G. Hemolyzed specimens: a major challenge for emergency departments and clinical laboratories. Crit Rev Clin Lab Sci 2011;48(3):143-53.
Lippi G, Montagnana M, Salvagno GL, Guidi GC. Interference of blood cell lysis on routine coagulation testing. Arch Pathol Lab Med 2006;130(2):181-4.
Lippi G, Becan-McBride K, Behúlová D, Bowen RA, Church S, Delanghe J, et al. Preanalytical quality improvement: in quality we trust. Clin Chem Lab Med 2013;51(1):229-41.
Lippi G, Guidi GC, Mattiuzzi C, Plebani M. Preanalytical variability: the dark side of the moon in laboratory testing. Clin Chem Lab Med 2006;44(4):358-65.
Bölenius K, Brulin C, Grankvist K, Lindkvist M, Söderberg J. A content validated questionnaire for assessment of self reported venous blood sampling practices. BMC Res Notes 2012;5:39.
Narayanan S. The preanalytic phase. An important component of laboratory medicine. Am J Clin Pathol 2000;113(3):429-52.
Plebani M. Quality indicators to detect pre-analytical errors in laboratory testing. Clin Biochem Rev 2012;33(3):85-8.
Ricós C, GarcÃa-Victoria M, de la Fuente B. Quality indicators and specifications for the extra-analytical phases in clinical laboratory management. Clin Chem Lab Med 2004;42(6):578-82.
Grecu DS, Vlad DC, Dumitrascu V. Quality indicators in the preanalytical phase of testing in a stat laboratory. Lab Med 2014;45(1):74-81.
Guder WG. History of the preanalytical phase: a personal view. Biochem Med (Zagreb) 2014;24(1):25-30.
Melkie M, Girma A, Tsalla T. The practice of venous blood collection among laboratory and non-laboratory professionals working in Ethiopian Government Hospitals: a comparative study. BMC Health Serv Res 2014;14:88.
Petersen PH, Fraser CG, Westgard JO, Larsen ML. Analytical goal-setting for monitoring patients when two analytical methods are used. Clin Chem 1992;38(11):2256-60.
Ross JW, Fraser MD. Analytical goals developed from the inherent error of medical tests. Clin Chem 1993;39(7):1481-93.
Shahangian S, Krolak JM, Gaunt EE, Cohn RD. A system to monitor a portion of the total testing process in medical clinics and laboratories: feasibility of a split-specimen design. Arch Pathol Lab Med 1998;122(6):503-11.
Bolann BJ, Stølsnes B. [Analytical uncertainty--how wrong can a laboratory result be?]. Tidsskr Nor Laegeforen 1999;119(30):4472-5.
Hollensead SC, Lockwood WB, Elin RJ. Errors in pathology and laboratory medicine: consequences and prevention. J Surg Oncol 2004;88(3):161-81.
Lippi G, Montagnana M, Giavarina D. National survey on the pre-analytical variability in a representative cohort of Italian laboratories. Clin Chem Lab Med 2006;44(12):1491-4.
Kirchner MJ, Funes VA, Adzet CB, Clar MV, Escuer MI, Girona JM, et al. Quality indicators and specifications for key processes in clinical laboratories: a preliminary experience. Clin Chem Lab Med 2007;45(5):672-7.
Lillo R, Salinas M, Lopez-Garrigos M, Naranjo-Santana Y, Gutiérrez M, MarÃn MD, et al. Reducing preanalytical laboratory sample errors through educational and technological interventions. Clin Lab 2012;58(9-10):911-7.
Salinas M, Lopez-Garrigos M, Flores E, Gutiérrez M, Lugo J, Uris J. Three years of preanalytical errors: quality specifications and improvement through implementation of statistical process control. Scand J Clin Lab Invest 2009;69(8):822-6.
Simundic AM, Lippi G. Preanalytical phase--a continuous challenge for laboratory professionals. Biochem Med (Zagreb). 2012;22(2):145-9.
Alsina MJ, Alvarez V, Barba N, Bullich S, Cortés M, Escoda I, et al. Preanalytical quality control program - an overview of results (2001-2005 summary). Clin Chem Lab Med 2008;46(6):849-54.
Downloads
Published
How to Cite
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
