engleski

Phlebotomy - the most critical extra-analytical procedure - multicentric survey study

Background: Our group recently reported the state of the quality of extra-analytical phase in some European countries and Mexico. Here we present a part of this previously published multicentric study. Our aim was to identify the most critical issues related to the blood sampling practices. Materials and methods: The survey included 3 clinical laboratories from Croatia and one from each of the following countries: Bosnia and Herzegovina, Czech Republic, Hungary, Mexico, Poland, Portugal, Romania, Serbia and Ukraine. Laboratory personnel completed questionnaire with Likert scaled questions (never=1, rarely=2, often=3, always=4 and sign x for not applicable) that were later scored (from 1-4). This study analyses part of original questionnaire regarding phlebotomy procedures: patient identification prior to sampling, order of draw, deviating from the recommended time for collecting fasting specimens early in the morning and recording the exact time of blood sampling. Subjects’ median age was 42 (20-75) years. Results: Total of 461 questionnaires was collected, 18 were excluded (<50% filled questionnaire) and the final number of questionnaires which qualified for statistical analysis was 443. We found that 79% of subjects never confirm patient’s identity with picture- based document although 93% of them always ask for patient’s name. Almost half of the subjects (45%) always accept samples collected after 11am if patient is coming from distant destinations. Regarding that last question, subjects from accredited laboratories or laboratories in preparation for accreditation had statistically significant (P<0.001) higher score (2.34±1.00) than subjects from nonaccredited laboratories (1.86±0.99). Also, there was a statistically significant difference in following the order of blood draw (P=0.007) and recording the exact time of blood sampling (P=0.001) between laboratories that have a written procedure for primary sample collection in comparison with laboratories that do not have it. Conclusions: Inappropriate patient identification and deviation from the recommended time for collecting fasting specimens early in the morning are identified as the most critical activities related to the phlebotomy practices, in our study. Laboratory accreditation and written procedures for primary sample collection are associated with substantial improvement of the quality of phlebotomy practices.

preanalytical phase; laboratory error; phlebotomy

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