title: Minor improvement of venous blood specimen collection practices in primary health care after a large-scale educational intervention.
abstract: BACKGROUND
  Venous blood specimen collection is a common health care practice that has to follow strict guidelines, non-compliance among sampling staff may compromise patient safety. We evaluated a large-scale 2 h educational intervention that emphasised guideline adherence to assess possible improvements of venous blood specimen collection practices.
  
  
  METHODS
  Blood specimen haemolysis is usually caused by inadequate venous blood specimen collection and handling, reflecting overall pre-analytical handling. We monitored haemolysis of serum samples with haemolysis index corresponding to ≥ 150 mg/L of free haemoglobin for specimens sent from 11 primary health care centres and analysed on a Vitros 5,1 clinical chemistry analyser before (2008, n = 6652 samples) and after (2010, n = 6121 samples) the intervention.
  
  
  RESULTS
  The total percentage of haemolysed specimens was 11.8 % compared to 10.5 % (p = 0.022) before the intervention. As groups, rural primary health care centres demonstrated a significant reduction [Odds ratios (OR) = 0.744] of haemolysed specimens after intervention, whereas urban primary health care centres demonstrated a significant increase (OR = 1.451) of haemolysis.
  
  
  CONCLUSIONS
  A large-scale 2 h educational intervention to make venous blood specimen collection staff comply with guideline practices had minor effects on collection practices. Educational interventions may be effective in wards/care centres demonstrating venous blood specimen collection practices with larger deviations from guidelines.
authors.affiliation: Department of Nursing, Umeå University, Building A, 4th floor, 901 87 Umeå, Sweden. karin.bolenius@nurs.umu.se
authors.forename: Karin
authors.initials: K
authors.lastname: Bölenius
authors.forename: Johan
authors.initials: J
authors.lastname: Söderberg
authors.forename: Johan
authors.initials: J
authors.lastname: Hultdin
authors.forename: Marie
authors.initials: M
authors.lastname: Lindkvist
authors.forename: Christine
authors.initials: C
authors.lastname: Brulin
authors.forename: Kjell
authors.initials: K
authors.lastname: Grankvist
mesh_terms: D000368:Aged; D005260:Female; D019983:Guideline Adherence; D006461:Hemolysis / Q000502:physiology*; D006801:Humans; D008297:Male; D013677:Medical Laboratory Science / Q000193:education* / Q000379:methods / Q000592:standards; D008875:Middle Aged; D018962:Phlebotomy / Q000379:methods* / Q000592:standards*; D011320:Primary Health Care / Q000379:methods* / Q000592:standards*; D019984:Quality Indicators, Health Care