title: [Influence of an observer in the haemolysis produced during the extraction of blood samples in primary care].
abstract: OBJECTIVE
  To check whether an intervention based on direct observation and complementary information to nurses helps reduce haemolysis when drawing blood specimens.
  
  
  METHODS
  Random sampling study in primary care centres in the serrania de Málaga health management area, using a cross-sectional, longitudinal pre- and post-intervention design. The study period was from August 2012 to January 2015. The level of free haemoglobin was measured by direct spectrophotometry in the specimens extracted. It was then checked whether the intervention influenced the level of haemolysis, and if this was maintained over time.
  
  
  RESULTS
  The mean haemolysis measured pre-intervention was 17%, and after intervention it was 6.1%. A year later and under the same conditions, the frequency of haemolysis was measured again the samples analysed, and the percentage was 9% These results are low when compared to the level obtained pre-intervention, but are higher when compared to the levels obtained immediately after the intervention. The transport and analysis conditions were the same.
  
  
  CONCLUSIONS
  An intervention based on a direct and informative observation in the process of collecting blood samples contributes significantly to reduce the level of haemolysis. This effect is maintained in time. This intervention needs to be repeated to maintain its effectiveness. Audits and continuing education programs are useful for quality assurance procedures, and maintain the level of care needed for a good quality of care.
authors.affiliation: Laboratorio Clínico, Hospital de la Serranía, Área de Gestión Sanitaria Serranía de Málaga, Ronda, Málaga, España.
authors.forename: N
authors.initials: N
authors.lastname: Bel-Peña
authors.affiliation: Laboratorio Clínico, Hospital de la Serranía, Área de Gestión Sanitaria Serranía de Málaga, Ronda, Málaga, España. Electronic address: nieves.bel.sspa@juntadeandalucia.es.
authors.forename: F J
authors.initials: FJ
authors.lastname: Mérida-de la Torre
mesh_terms: D001800:Blood Specimen Collection / Q000451:nursing*; D003430:Cross-Sectional Studies; D006452:Hemoglobinometry; D006461:Hemolysis; D006801:Humans; D009731:Nursing Audit; D009934:Organization and Administration; D018962:Phlebotomy / Q000451:nursing*; D011446:Prospective Studies; D058996:Quality Improvement; D012494:Sampling Studies
keywords: Auditoría de enfermería; Haemolysis; Hemólisis; Laboratory test; Mejoría de la calidad; Nursing audit; Prueba de laboratorio; Quality improvement