Skip to main content
Top
Published in: BMC Health Services Research 1/2014

Open Access 01-12-2014 | Research article

The practice of venous blood collection among laboratory and non-laboratory professionals working in Ethiopian Government Hospitals: a comparative study

Authors: Mulugeta Melkie, Abel Girma, Tsegaye Tsalla

Published in: BMC Health Services Research | Issue 1/2014

Login to get access

Abstract

Background

Pre-analytical phase of overall laboratory testing system continues to be the major source of errors that affect patient safety and health care system. One of the activities in this phase is venous blood collection (VBC), the most common type of specimen drawn or sent to clinical laboratories for further analysis; and the source for a potentially numerous types of errors. In this study, we focused on determining and comparing desirability/undesirability of activities during VBC in Ethiopian hospitals among different groups of professionals.

Methods

We conducted a cross-sectional comparative study in three government hospitals in South Ethiopia from February 2012 to September 2012. Randomly selected professionals who participate in VBC in outpatient and inpatient departments were requested to fill in structured and pretested questionnaire regarding their practice of VBC and their replies were categorized as ‘desirable’ and ‘undesirable’ according to Clinical and Laboratory Standards Institute (CLSI) standard. Then, data was analyzed using Medcalc® version 12.1.4 software. P value of less than 0.05 was considered as statistically significant.

Results

In our study, 120 professionals were included among which 15.8% (n = 19) were laboratory professionals while the remaining 84.2% (n = 101) were non-laboratory professionals. Conscious patient identification in pre-collection phase of VBC and position of patients’ hands in actual collection phase of VBC involved the highest proportion of undesirability among both groups of professionals. However, in the post collection phase, specimen transferring from syringes to test tubes (15.8%) and mixing specimen with additives (63.4%) involved highest proportions of undesirability among laboratory and non-laboratory professionals respectively. Laboratory professionals reported better desirable practice in patient identification frequency, labeling and checking expiry dates of test tubes, specimen transfer and transport practices.

Conclusion

In conclusion, preparatory activities of VBC involved the highest proportions of undesirable practices among both groups of professionals. However, relatively better proportions of desirability were seen among laboratory professionals than non-laboratory professionals in some pre- and post-collection phase activities. The difference might be seen as a result of better qualification, education and training experience on VBC among laboratory professionals.
Literature
1.
go back to reference LLopis MA, Alvarez V, Martínez-Brú C, Gómez R, Barba N, Ibarz M, Cortés M, Ventura M, Alsina MJ: Quality Assurance in the Preanalytical Phase. 2012, Spain: The Spanish Society of Clinical Chemistry Committee for the extra-analytical quality assessment, 185-204. LLopis MA, Alvarez V, Martínez-Brú C, Gómez R, Barba N, Ibarz M, Cortés M, Ventura M, Alsina MJ: Quality Assurance in the Preanalytical Phase. 2012, Spain: The Spanish Society of Clinical Chemistry Committee for the extra-analytical quality assessment, 185-204.
2.
go back to reference Bonini P, Plebani M, Ceriotti F, Rubboli F: Errors in laboratory medicine. Clin Chem. 2002, 48 (5): 691-698.PubMed Bonini P, Plebani M, Ceriotti F, Rubboli F: Errors in laboratory medicine. Clin Chem. 2002, 48 (5): 691-698.PubMed
3.
go back to reference Goswami B, Singh B, Chawla R, Mallika V: Evaluation of errors in a clinical laboratory: a one-year experience. Clin Chem Lab Med. 2010, 48 (1): 63-66.CrossRefPubMed Goswami B, Singh B, Chawla R, Mallika V: Evaluation of errors in a clinical laboratory: a one-year experience. Clin Chem Lab Med. 2010, 48 (1): 63-66.CrossRefPubMed
4.
go back to reference Plebani M: Errors in clinical laboratories or errors in laboratory medicine?. Clin Chem Lab Med. 2006, 44 (6): 750-759.PubMed Plebani M: Errors in clinical laboratories or errors in laboratory medicine?. Clin Chem Lab Med. 2006, 44 (6): 750-759.PubMed
5.
go back to reference Hollensead SC, Lockwood WB, Elin RJ: Errors in pathology and laboratory medicine: consequences and prevention. J Surg Oncol. 2004, 88: 161-181. 10.1002/jso.20125.CrossRefPubMed Hollensead SC, Lockwood WB, Elin RJ: Errors in pathology and laboratory medicine: consequences and prevention. J Surg Oncol. 2004, 88: 161-181. 10.1002/jso.20125.CrossRefPubMed
7.
go back to reference Plebani M, Carraro P: Mistakes in a stat laboratory: types and frequency. Clin Chem. 1997, 43: 1348-1351.PubMed Plebani M, Carraro P: Mistakes in a stat laboratory: types and frequency. Clin Chem. 1997, 43: 1348-1351.PubMed
8.
go back to reference Rattan A, Lippi G: Frequency and type of preanalytical errors in a laboratory medicine department in India. Clin Chem Lab Med. 2008, 46 (11): 1657-1659.CrossRefPubMed Rattan A, Lippi G: Frequency and type of preanalytical errors in a laboratory medicine department in India. Clin Chem Lab Med. 2008, 46 (11): 1657-1659.CrossRefPubMed
9.
go back to reference Carraro P, Plebani M: Errors in a stat laboratory: types and frequencies 10 years later. Clin Chem. 2007, 53 (7): 1338-1342. 10.1373/clinchem.2007.088344.CrossRefPubMed Carraro P, Plebani M: Errors in a stat laboratory: types and frequencies 10 years later. Clin Chem. 2007, 53 (7): 1338-1342. 10.1373/clinchem.2007.088344.CrossRefPubMed
10.
go back to reference Lippi G, Salvagno GL, Montagnana M, Franchini M, Guidi GC: Phlebotomy issues and quality improvement in results of laboratory testing. Clin Lab. 2006, 52: 217-230.PubMed Lippi G, Salvagno GL, Montagnana M, Franchini M, Guidi GC: Phlebotomy issues and quality improvement in results of laboratory testing. Clin Lab. 2006, 52: 217-230.PubMed
11.
go back to reference Clinical and Laboratory Standards Institute (CLSI): Procedures for the Collection of Diagnostic Blood Specimens by Venipuncture; Approved Standard. 2007, CLSI, 940 West Valley Road, Suite 1400, Wayne, Pennsylvania 19087–1898 USA: CLSI document H3-A6 (ISBN 1-56238-650-6) Clinical and Laboratory Standards Institute (CLSI): Procedures for the Collection of Diagnostic Blood Specimens by Venipuncture; Approved Standard. 2007, CLSI, 940 West Valley Road, Suite 1400, Wayne, Pennsylvania 19087–1898 USA: CLSI document H3-A6 (ISBN 1-56238-650-6)
12.
go back to reference Wallin O, Söderberg J, Van Guelpen B, Stenlund H, Grankvist K, Brulin C: Blood sample collection and patient identification demand improvement: a questionnaire study of preanalytical practices in hospital wards and laboratories. Scand J Caring Sci. 2010, 24: 581-591. 10.1111/j.1471-6712.2009.00753.x.CrossRefPubMed Wallin O, Söderberg J, Van Guelpen B, Stenlund H, Grankvist K, Brulin C: Blood sample collection and patient identification demand improvement: a questionnaire study of preanalytical practices in hospital wards and laboratories. Scand J Caring Sci. 2010, 24: 581-591. 10.1111/j.1471-6712.2009.00753.x.CrossRefPubMed
13.
go back to reference Wiwanitkit V: Types and frequency of preanalytical mistakes in the first Thai ISO 9002:1994 certified clinical laboratory, a 6 – month monitoring. BMC Clin Pathol. 2001, 1 (5): 5.CrossRefPubMedPubMedCentral Wiwanitkit V: Types and frequency of preanalytical mistakes in the first Thai ISO 9002:1994 certified clinical laboratory, a 6 – month monitoring. BMC Clin Pathol. 2001, 1 (5): 5.CrossRefPubMedPubMedCentral
14.
go back to reference Renner SW, Howanitz PJ, Bachner P: Wristband identification error reporting in 712 hospitals. A College of American Pathologists’ Q-Probes study of quality issues in transfusion practice. Arch Pathol Lab Med. 1993, 117: 573-577.PubMed Renner SW, Howanitz PJ, Bachner P: Wristband identification error reporting in 712 hospitals. A College of American Pathologists’ Q-Probes study of quality issues in transfusion practice. Arch Pathol Lab Med. 1993, 117: 573-577.PubMed
15.
go back to reference Lippi G, Blanckaert N, Bonini P, Green S, Kitchen S, Palicka V, Vassault AJ, Plebani M: Causes, consequences, detection, and prevention of identification errors in laboratory diagnostics. Clin Chem Lab Med. 2009, 47 (2): 143-153.CrossRefPubMed Lippi G, Blanckaert N, Bonini P, Green S, Kitchen S, Palicka V, Vassault AJ, Plebani M: Causes, consequences, detection, and prevention of identification errors in laboratory diagnostics. Clin Chem Lab Med. 2009, 47 (2): 143-153.CrossRefPubMed
16.
go back to reference Maw GJ, Mackenzie IL, Taylor NA: Redistribution of body fluids during postural manipulations. Acta Physiol Scand. 1995, 155: 157-163. 10.1111/j.1748-1716.1995.tb09960.x.CrossRefPubMed Maw GJ, Mackenzie IL, Taylor NA: Redistribution of body fluids during postural manipulations. Acta Physiol Scand. 1995, 155: 157-163. 10.1111/j.1748-1716.1995.tb09960.x.CrossRefPubMed
17.
go back to reference International Standards Institute ISO 15189: Medical laboratories-Particular requirements for quality and competence. 2007 International Standards Institute ISO 15189: Medical laboratories-Particular requirements for quality and competence. 2007
18.
go back to reference Chawla R, Goswami B, Tayal D, Mallika V: Identification of the types of preanalytical errors in the clinical chemistry laboratory: 1-year study at G.B. Pant hospital. Lab Medicine. 2010, 41 (2): 89-92. 10.1309/LM9JXZBMLSVJT9RK.CrossRef Chawla R, Goswami B, Tayal D, Mallika V: Identification of the types of preanalytical errors in the clinical chemistry laboratory: 1-year study at G.B. Pant hospital. Lab Medicine. 2010, 41 (2): 89-92. 10.1309/LM9JXZBMLSVJT9RK.CrossRef
19.
go back to reference Simundic AM, Nikolac N, Vukasovic I, Vrkic N: The prevalence of preanalytical errors in a Croatian ISO 15189 accredited laboratory. Clin Chem Lab Med. 2010, 48 (7): 1009-1014.CrossRefPubMed Simundic AM, Nikolac N, Vukasovic I, Vrkic N: The prevalence of preanalytical errors in a Croatian ISO 15189 accredited laboratory. Clin Chem Lab Med. 2010, 48 (7): 1009-1014.CrossRefPubMed
20.
go back to reference Valenstein PN, Raab SS, Walsh MK: Identification errors involving clinical laboratories: a College of American Pathologists Q-Probes study of patient and specimen identification errors at 120 institutions. Arch Pathol Lab Med. 2006, 130: 1106-1113.PubMed Valenstein PN, Raab SS, Walsh MK: Identification errors involving clinical laboratories: a College of American Pathologists Q-Probes study of patient and specimen identification errors at 120 institutions. Arch Pathol Lab Med. 2006, 130: 1106-1113.PubMed
21.
go back to reference Polack B, Schved JF, Boneu B: Preanalytical recommendations of the ‘Groupe d’Etude sur l‘Hemostase et la Thrombose’ (GEHT) for venous blood testing in hemostasis laboratories. Haemostasis. 2001, 31: 61-68.PubMed Polack B, Schved JF, Boneu B: Preanalytical recommendations of the ‘Groupe d’Etude sur l‘Hemostase et la Thrombose’ (GEHT) for venous blood testing in hemostasis laboratories. Haemostasis. 2001, 31: 61-68.PubMed
22.
go back to reference Murphy MF, Stearn BE, Dzik WH: Current performance of patient sample collection in the UK. Transfus Med. 2004, 14: 113-121. 10.1111/j.0958-7578.2004.0488.x.CrossRefPubMed Murphy MF, Stearn BE, Dzik WH: Current performance of patient sample collection in the UK. Transfus Med. 2004, 14: 113-121. 10.1111/j.0958-7578.2004.0488.x.CrossRefPubMed
23.
go back to reference Nigam PK: Preanalytical errors: some common errors in blood specimen collection for routine investigations in hospital patients. Journal of Clinical and Diagnostic Research. 2011, 5 (3): 659-661. Nigam PK: Preanalytical errors: some common errors in blood specimen collection for routine investigations in hospital patients. Journal of Clinical and Diagnostic Research. 2011, 5 (3): 659-661.
25.
go back to reference Burns ER, Yoshikawa N: Hemolysis in serum samples drawn by emergency department personnel versus laboratory phlebotomists. Lab Med. 2002, 33: 378-380. 10.1309/PGM4-4F8L-2P1M-LKPB.CrossRef Burns ER, Yoshikawa N: Hemolysis in serum samples drawn by emergency department personnel versus laboratory phlebotomists. Lab Med. 2002, 33: 378-380. 10.1309/PGM4-4F8L-2P1M-LKPB.CrossRef
26.
go back to reference Saleem S, Mani V, Chadwick MA, Creanor S, Ayling RM: A prospective study of causes of hemolysis during venipuncture: tourniquet time should be kept to a minimum. Ann Clin Biochem. 2009, 46: 244-246. 10.1258/acb.2009.008228.CrossRefPubMed Saleem S, Mani V, Chadwick MA, Creanor S, Ayling RM: A prospective study of causes of hemolysis during venipuncture: tourniquet time should be kept to a minimum. Ann Clin Biochem. 2009, 46: 244-246. 10.1258/acb.2009.008228.CrossRefPubMed
27.
go back to reference Lima-Oliveira G, Lippi G, Salvagno GL, Montagnana M, Manguera CLP, Sumita NM, Picheth G, Guidi GC, Scartezini M: New ways to deal with known preanalytical issues: use of transilluminator instead of tourniquet for easing vein access and eliminating stasis on clinical biochemistry. Biochemia Medica. 2011, 21 (2): 152-159.CrossRefPubMed Lima-Oliveira G, Lippi G, Salvagno GL, Montagnana M, Manguera CLP, Sumita NM, Picheth G, Guidi GC, Scartezini M: New ways to deal with known preanalytical issues: use of transilluminator instead of tourniquet for easing vein access and eliminating stasis on clinical biochemistry. Biochemia Medica. 2011, 21 (2): 152-159.CrossRefPubMed
28.
go back to reference Serdar MA, Kenar L, Haşim A, Koçu L, Türkmen YH, Kurt İ, Akman Ş, Erbil MK: Tourniquet application time during phlebotomy and the influence on clinical chemistry testing; is it negligible?. Turk J Biochem. 2008, 33 (3): 85-88. Serdar MA, Kenar L, Haşim A, Koçu L, Türkmen YH, Kurt İ, Akman Ş, Erbil MK: Tourniquet application time during phlebotomy and the influence on clinical chemistry testing; is it negligible?. Turk J Biochem. 2008, 33 (3): 85-88.
29.
go back to reference Clinical and Laboratory Standards Institute (CLSI): Procedures for the Handling and Processing of Blood Specimens; Approved Guideline—Forth Edition. 2010, CLSI, 940 West Valley Road, Suite 1400, Wayne, Pennsylvania 19087–1898 USA: CLSI document H18-A4 (ISBN 1-56238-724-3) Clinical and Laboratory Standards Institute (CLSI): Procedures for the Handling and Processing of Blood Specimens; Approved Guideline—Forth Edition. 2010, CLSI, 940 West Valley Road, Suite 1400, Wayne, Pennsylvania 19087–1898 USA: CLSI document H18-A4 (ISBN 1-56238-724-3)
Metadata
Title
The practice of venous blood collection among laboratory and non-laboratory professionals working in Ethiopian Government Hospitals: a comparative study
Authors
Mulugeta Melkie
Abel Girma
Tsegaye Tsalla
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2014
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-14-88

Other articles of this Issue 1/2014

BMC Health Services Research 1/2014 Go to the issue