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

  • Karin Bölenius EMAIL logo , Johan Söderberg , Johan Hultdin , Marie Lindkvist , Christine Brulin and Kjell Grankvist
Published/Copyright: August 7, 2012
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 51 Issue 2

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.

Keywords: haemolysis; intervention; medical errors; primary health care; quality indicator; venous blood specimen collection
Corresponding author: Karin Bölenius, Department of Nursing, Umeå University, Building A, 4th floor, 901 87 Umeå, Sweden Phone: +46 09 7859115, Fax: +46 90 7869851

This work would not have been possible without Jenny Ekman and Annika Wästerby who retrieved haemolysis data and the laboratory instructors Susanne Hermansson, Ann-Britt Lindström, Marie Backlund and Marie Lundgren who performed the educational intervention. We would like to thank the Faculty of Medicine, Umeå University, Umeå, Sweden, the Swedish National Board of Health and Welfare, Sweden and Västerbotten County Council in Sweden for research funding.

Conflict of interest statement

Authors’ conflict of interest disclosure: The authors stated that there are no conflicts of interest regarding the publication of this article.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Authors’ contributions: KB, JS, CB and KG proposed the original idea for the study. KB and JH collected the data and executed the statistical analyses together with ML. KB drafted the manuscript and all the authors read the manuscript critically for important intellectual content and approved the final manuscript.

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Received: 2012-03-14
Accepted: 2012-07-03
Published Online: 2012-08-07
Published in Print: 2013-02-01

©2013 by Walter de Gruyter Berlin Boston

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https://doi.org/10.1515/cclm-2012-0159
Keywords for this article
haemolysis; intervention; medical errors; primary health care; quality indicator; venous blood specimen collection

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