title: Nationwide survey of policies and practices related to capillary blood sampling in medical laboratories in Croatia.
abstract: BACKGROUND
  Capillary sampling is increasingly used to obtain blood for laboratory tests in volumes as small as necessary and as non-invasively as possible. Whether capillary blood sampling is also frequent in Croatia, and whether it is performed according to international laboratory standards is unclear.
  
  
  METHODS
  All medical laboratories that participate in the Croatian National External Quality Assessment Program (N = 204) were surveyed on-line to collect information about the laboratory's parent institution, patient population, types and frequencies of laboratory tests based on capillary blood samples, choice of reference intervals, and policies and procedures specifically related to capillary sampling. Sampling practices were compared with guidelines from the Clinical and Laboratory Standards Institute (CLSI) and the World Health Organization (WHO).
  
  
  RESULTS
  Of the 204 laboratories surveyed, 174 (85%) responded with complete questionnaires. Among the 174 respondents, 155 (89%) reported that they routinely perform capillary sampling, which is carried out by laboratory staff in 118 laboratories (76%). Nearly half of respondent laboratories (48%) do not have a written protocol including order of draw for multiple sampling. A single puncture site is used to provide capillary blood for up to two samples at 43% of laboratories that occasionally or regularly perform such sampling. Most respondents (88%) never perform arterialisation prior to capillary blood sampling.
  
  
  CONCLUSIONS
  Capillary blood sampling is highly prevalent in Croatia across different types of clinical facilities and patient populations. Capillary sampling procedures are not standardised in the country, and the rate of laboratory compliance with CLSI and WHO guidelines is low.
authors.affiliation: Children's Hospital Zagreb, Department of Laboratory Diagnostics, Zagreb, Croatia.
authors.forename: Jasna Lenicek
authors.initials: JL
authors.lastname: Krleza
mesh_terms: D001800:Blood Specimen Collection / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D002196:Capillaries; D017523:Croatia / Q000453:epidemiology; D003625:Data Collection; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006291:Health Policy; D006801:Humans; D007753:Laboratories / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000706:statistics & numerical data*; D011785:Quality Assurance, Health Care; D011795:Surveys and Questionnaires; D014944:World Health Organization
keywords: blood specimen collection; capillaries; diagnostic techniques and procedures; standardisation