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   Blood sample collection and patient identification demand improvement: a questionnaire study of preanalytical practices in hospital wards and laboratories


BACKGROUND
Most errors in venous blood testing result from human mistakes occurring before the sample reach the laboratory.


OBJECTIVE
To survey venous blood sampling (VBS) practices in hospital wards and to compare practices with hospital laboratories.


METHODS
Staff in two hospitals (all wards) and two hospital laboratories (314 respondents, response rate 94%), completed a questionnaire addressing issues relevant to the collection of venous blood samples for clinical chemistry testing.


RESULTS
The findings suggest that instructions for patient identification and the collection of venous blood samples were not always followed. For example, 79% of the respondents reported the undesirable practice (UDP) of not always using wristbands for patient identification. Similarly, 87% of the respondents noted the UDP of removing venous stasis after the sampling is finished. Compared with the ward staff, a significantly higher proportion of the laboratory staff reported desirable practices regarding the collection of venous blood samples. Neither education nor the existence of established sampling routines was clearly associated with VBS practices among the ward staff.


CONCLUSIONS
The results of this study, the first of its kind, suggest that a clinically important risk of error is associated with VBS in the surveyed wards. Most important is the risk of misidentification of patients. Quality improvement of blood sample collection is clearly needed, particularly in hospital wards.
Department of Nursing, Umeå University, Umeå, Sweden. olof.wallin@medbio.umu.se
Olof
O
Wallin
Johan
J
Söderberg
Bethany
B
Van Guelpen
Hans
H
Stenlund
Kjell
K
Grankvist
Christine
C
Brulin
D003430:Cross-Sectional Studies; D005260:Female; D006748:Hospital Departments; D006801:Humans; D007755:Laboratories, Hospital; D008297:Male; D008875:Middle Aged; D010355:Patient Identification Systems; D018962:Phlebotomy; D013048:Specimen Handling; D011795:Surveys and Questionnaires