Minor improvement of venous blood specimen collection practices in primary health care after a large-scale educational intervention

Clin Chem Lab Med. 2013 Feb;51(2):303-10. doi: 10.1515/cclm-2012-0159.

Abstract

Background: Venous blood specimen collection is a common health care practice that has to follow strict guidelines, non-compliance among sampling staff may compromise patient safety. We evaluated a large-scale 2 h educational intervention that emphasised guideline adherence to assess possible improvements of venous blood specimen collection practices.

Methods: Blood specimen haemolysis is usually caused by inadequate venous blood specimen collection and handling, reflecting overall pre-analytical handling. We monitored haemolysis of serum samples with haemolysis index corresponding to ≥ 150 mg/L of free haemoglobin for specimens sent from 11 primary health care centres and analysed on a Vitros 5,1 clinical chemistry analyser before (2008, n = 6652 samples) and after (2010, n = 6121 samples) the intervention.

Results: The total percentage of haemolysed specimens was 11.8 % compared to 10.5 % (p = 0.022) before the intervention. As groups, rural primary health care centres demonstrated a significant reduction [Odds ratios (OR) = 0.744] of haemolysed specimens after intervention, whereas urban primary health care centres demonstrated a significant increase (OR = 1.451) of haemolysis.

Conclusions: A large-scale 2 h educational intervention to make venous blood specimen collection staff comply with guideline practices had minor effects on collection practices. Educational interventions may be effective in wards/care centres demonstrating venous blood specimen collection practices with larger deviations from guidelines.

MeSH terms

  • Aged
  • Female
  • Guideline Adherence
  • Hemolysis / physiology*
  • Humans
  • Male
  • Medical Laboratory Science / education*
  • Medical Laboratory Science / methods
  • Medical Laboratory Science / standards
  • Middle Aged
  • Phlebotomy / methods*
  • Phlebotomy / standards*
  • Primary Health Care / methods*
  • Primary Health Care / standards*
  • Quality Indicators, Health Care