Improving Phlebotomy Practices Through Small-Volume Blood Tubes: A Survey-Based Study

Yıl 2024, Cilt: 6 Sayı: 1, 95 - 101, 31.01.2024

Fatma Demet Arslan , Tuğba Öncel Van , Canan Alpşen Sevgi Çınar , Mehmet Köseoğlu

https://doi.org/10.37990/medr.1404771

Cited By: 2

https://izlik.org/JA26SW59KE

Öz

Aim: The blood collection for laboratory tests has been frequently performed due to evidence-based medicine. We aimed to conduct a survey on phlebotomy among phlebotomists and patients and to reduce unnecessary blood loss by using small-volume blood collection tubes.
Material and Method: A survey among phlebotomists and patients was conducted to gather their opinions. Phlebotomists received training on the importance of the preanalytical process. The blood volume required for laboratory tests was reduced by 33.3%-50.0% in children and adults, and 63.0%-84.0% in newborns. Following this intervention, we investigated its effects on the blood transfusion ratio in the neonatal and adult intensive care unit (NICU and ICU) and the amount of laboratory medical waste generated.
Results: A majority of phlebotomists (91.8%) reported difficulties in drawing blood from newborns, pediatric, oncology, hematology, and geriatric patients. Additionally, 68.9% of phlebotomists and 57.1% of patients expressed an opinion for reduced blood volume. Despite an increase in the number of laboratory tests (28.4%) and samples (15.7%), we observed a 17.8% reduction in the amount of laboratory medical waste. Although the number of patients in NICU increased statistically significant, the increase in transfusion rates was not significant. Although the number of patients in ICU increased, transfusion rates decreased, but neither was found to be statistically significant.
Conclusion: Post-graduation, phlebotomists should be educated regularly about the preanalytical process. Based on the opinions of both phlebotomists and patients, using small-volume tubes in patients with difficult blood collection may increase their satisfaction. Generally, laboratory medical waste may be reduced.

Anahtar Kelimeler

Laboratory testing , blood collection tube , iatrogenic anemia , patient satisfaction , personnel satisfaction , laboratory medical waste.

Kaynakça

• Choorapoikayil S, Zacharowski K, Füllenbach C, Meybohm P. Patient blood management in critically III. In: Shander A, Corwin HL, eds, Hematologic challenges in the critically III. Springer International Publishing. 2018;407-23.
• Martin ND, Scantling D. Hospital-acquired anemia: a contemporary review of etiologies and prevention strategies. J Infus Nurs. 2015;38:330-8.
• Eaton KP, Levy K, Soong C, et al. Evidence-based guidelines to eliminate repetitive laboratory testing. JAMA Intern Med. 2017;177:1833-9.
• Kaushansky K, Lichtman MA, Prchal J, et al. Williams Hematology, 9th ed. New York: McGraw-Hill Education; 2016.
• Corwin HL, Gettinger A, Pearl RG, et al. The CRIT study: anemia and blood transfusion in the critically ill-current clinical practice in the United States. Crit Care Med. 2004;32:39-52.
• Widness JA. Pathophysiology of anemia during the neonatal period, including anemia of prematurity. Neoreviews. 2008;9:e520.
• Sanchez-Giron F, Alvarez-Mora F. Reduction of blood loss from laboratory testing in hospitalized adult patients using small-volume (pediatric) tubes. Arch Pathol Lab Med. 2008;132:1916-9.
• Dale JC, Ruby SG. Specimen collection volumes for laboratory tests: A College of American Pathologists study of 140 laboratories. Arch Pathol Lab Med. 2003;127:162-8.
• Lee BK, Ellenbecker MJ, Moure-Eraso R. Analyses of the recycling potential of medical plastic wastes. Waste Manag. 2002;22:461-70.
• Duan X, Shao W, Jiang W, et al. Status of phlebotomy tube utilization at a major medical center. Are we using too many phlebotomy tubes?. Heliyon. 2023;9:e15334.
• McAlister S, Barratt AL, Bell KJ, Mcgain F. The carbon footprint of pathology testing. Med J Aust. 2020;212:377-82.
• Helmer P, Hottenrott S, Steinisch A, et al. Avoidable blood loss in critical care and patient blood management: scoping review of diagnostic blood loss. J Clin Med. 2022;11:320.
• Dolman HS, Evans K, Zimmerman LH, et al. Impact of minimizing diagnostic blood loss in the critically ill. Surgery. 2015;158:1083-7.
• Kurniali PC, Curry S, Brennan KW, et al. A retrospective study investigating the incidence and predisposing factors of hospital-acquired anemia. Anemia. 2014;2014:634582.
• Foulke GE, Harlow DJ. Effective measures for reducing blood loss from diagnostic laboratory tests in intensive care unit patients. Crit Care Med. 1989;17:1143-5.
• Lennox S, Bench S. Blood sampling in adult critical care: a mixed methods study. Int J Orthop and Trauma Nurs. 2022;45:100923.
• Matzek LJ, LeMahieu AM, Madde NR, et al. A contemporary analysis of phlebotomy and iatrogenic anemia development throughout hospitalization in critically ill adults. Anesth Analg. 2022;135:501-10.