title: Findings of Phlebotomy Practices in Kenya in 2010: Need for Action.
abstract: BACKGROUND
  Phlebotomy, a commonly performed medical procedure in healthcare, is essential for disease diagnosis and patient management. However, poorly performed phlebotomy can compromise patient safety, healthcare worker (HCW) safety, and specimen quality. We carried out a study between June and July 2010 to assess knowledge, quality and safety of phlebotomy before implementation of a public-private partnership between Becton, Dickinson and Company and the US President's Emergency Plan for AIDS Relief.
  
  
  METHODS
  This was a cross-sectional observational study in 8 healthcare facilities within 4 regions of Kenya. HCWs were observed conducting venous and capillary blood collections, and pre- and posttests were offered during HCW training.
  
  
  RESULTS
  Of 283 blood samples obtained, 194 were venous draws conducted by 72 HCWs and 89 were capillary draws performed by 33 HCWs. Based on 12 preset quality-associated criteria, none of the 194 observed phlebotomies met the standard. In total, 91 HCWs were trained in phlebotomy. The mean knowledge increase between pre- and posttraining test was 41%, ranging from 39% to 45% (95% confidence interval, 29.3%-53.5%;P< .001).
  
  
  CONCLUSIONS
  Inadequate knowledge and imperfect phlebotomy procedures were noted. This formed the basis for the safe phlebotomy partnership to address these deficiencies. To ensure sustainability, safe phlebotomy practices were integrated into preservice training.
authors.affiliation: Division of Global HIV/AIDS, US Centers for Disease Control and Prevention.
authors.forename: Daniel
authors.initials: D
authors.lastname: Kimani
authors.affiliation: Ministry of Public Health and Sanitation, National AIDS and STI Control Program.
authors.forename: Rachel
authors.initials: R
authors.lastname: Kamau
authors.affiliation: Becton, Dickinson and Company (BD), Franklin Lakes, New Jersey.
authors.forename: Renuka
authors.initials: R
authors.lastname: Gadde
authors.affiliation: Division of Global HIV/AIDS, US Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Dejana
authors.initials: D
authors.lastname: Selenic
authors.affiliation: Jhpiego, Nairobi, Kenya.
authors.forename: Stephen
authors.initials: S
authors.lastname: Maina
authors.affiliation: Division of Global HIV/AIDS, US Centers for Disease Control and Prevention, Lusaka, Zambia.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Marum
authors.affiliation: Division of Global HIV/AIDS, US Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Gao
authors.initials: G
authors.lastname: Hongjiang
authors.affiliation: Division of Global HIV/AIDS, US Centers for Disease Control and Prevention.
authors.forename: Samuel
authors.initials: S
authors.lastname: Mwalili
authors.affiliation: Division of Global HIV/AIDS, US Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Anthony
authors.initials: A
authors.lastname: Marfin
authors.affiliation: Division of Global HIV/AIDS, US Centers for Disease Control and Prevention.
authors.forename: Jane
authors.initials: J
authors.lastname: Mwangi
mesh_terms: D001800:Blood Specimen Collection / Q000592:standards*; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000458:organization & administration; D006282:Health Personnel; D006801:Humans; D007630:Kenya; D018962:Phlebotomy / Q000592:standards*; D055818:Public-Private Sector Partnerships; D011786:Quality Control; D012449:Safety
keywords: blood specimen quality; phlebotomy; preanalytical errors; public-private partnerships