title: The effective reduction of tourniquet application time after minor modification of the CLSI H03-A6 blood collection procedure.
abstract: BACKGROUND
  The phlebotomists' procedures are a still source of laboratory variability. The aim of this study was to verify the efficacy of minor modification in procedure for collection of diagnostic blood specimens by venipuncture from CLSI H03-A6 document is able to reduce the tourniquet application time.
  
  
  METHODS
  Thirty phlebotomists were invited to participate. Each phlebotomist was trained individually to perform the new venipuncture procedure that shortens the time of tourniquet release and removal. The phlebotomy training program was delivered over 8h. After training, all phlebotomists were monitored for 20 working days, to guarantee the adoption of the correct new procedures for collection of diagnostic blood specimens. After this time frame the phlebotomists were evaluated to verify whether the new procedure for blood collection derived from CLSI H03-A6 document was effective to improve the quality process by decrease in tourniquet application time. We compared the tourniquet application time and qualitative difference of phlebotomy procedures between laboratories before and after phlebotomy training.
  
  
  RESULTS
  The overall mean +/- SD tourniquet application time before and afterthis intervention were 118 +/- 1 s and 30 +/- 1 s respectively. Minor modifications in procedure for blood collection were able to reduce significantly the tourniquet application time (-88 s, P < 0.001).
  
  
  CONCLUSIONS
  The minor modifications in procedure for collection of diagnostic blood specimens by venipuncture from CLSI H03-A6 document were able to reduce the tourniquet application time. Now the proposed new procedure for collection of diagnostic blood specimens by venipuncture could be considered usefulness and should be put into practice by all quality laboratory managers and/or phlebotomy coordinators to avoid preanalytical errors regard venous stasis and guarantee patient safety.
authors.affiliation: Laboratory of Clinical Biochemistry, Department of Life and Reproduction Sciences, University of Verona, Italy. dr.g.lima.oliveira@gmail.com
authors.forename: Gabriel
authors.initials: G
authors.lastname: Lima-Oliveira
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lippi
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Salvagno
authors.forename: Martina
authors.initials: M
authors.lastname: Montagnana
authors.forename: Geraldo
authors.initials: G
authors.lastname: Picheth
authors.forename: Gian Cesare
authors.initials: GC
authors.lastname: Guidi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D057189:Checklist; D005260:Female; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000517:prevention & control / Q000706:statistics & numerical data; D008875:Middle Aged; D061214:Patient Safety; D018962:Phlebotomy / Q000295:instrumentation / Q000379:methods*; D013997:Time Factors; D014111:Tourniquets; D055815:Young Adult