Impact of total automation consolidating first-line laboratory tests on diagnostic blood loss
-
Sara Pasqualetti
,
Elena Aloisio
Abstract
Background
Blood loss for laboratory testing may contribute to hospital-acquired anemia. When implementing the core laboratory (core-lab) section, we consolidated first-line tests decreasing the number of tubes previously dispatched to different sites. Here, hypothesized benefits of the amount of blood volume drawn were explored.
Methods
We retrieved, using a laboratory information system (LIS), the number of tubes received by laboratories interested in the change from all clinical wards in a year-based period, i.e. 2013 for pre-core-lab and 2015 for core-lab system, respectively. Data were expressed as the overall number of tubes sent to laboratories, the corresponding blood volume, and the number of laboratory tests performed, normalized for the number of inpatients.
Results
After consolidation, the average number of blood tubes per inpatient significantly decreased (12.6 vs. 10.7, p < 0.001). However, intensive care units (ICUs) did not reduce the number of tubes per patient, according to the needs of daily monitoring of their clinical status. The average blood volume sent to laboratories did not vary significantly because serum tubes for core-lab required higher volumes for testing up to 55 analytes in the same transaction. Finally, the number of requested tests per patient during the new osystem slightly decreased (−2.6%).
Conclusions
Total laboratory automation does not automatically mean reducing iatrogenic blood loss. The new system affected the procedure of blood drawing in clinical wards by significantly reducing the number of handled tubes, producing a benefit in terms of costs, labor and time consumption. Except in ICUs, this also slightly promoted some blood saving. ICUs which engage in phlebotomizing patients daily, did not take advantage from the test consolidation.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
Ethical approval: Not applicable.
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©2019 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Editorial
- Identification and management of spurious hemolysis: controversies, concerns and criticisms
- Reviews
- CYP24A1 and SLC34A1 genetic defects associated with idiopathic infantile hypercalcemia: from genotype to phenotype
- Meta-analysis: compared with anti-CCP and rheumatoid factor, could anti-MCV be the next biomarker in the rheumatoid arthritis classification criteria?
- Opinion Paper
- Collection, transport and storage procedures for blood culture specimens in adult patients: recommendations from a board of Italian experts
- General Clinical Chemistry and Laboratory Medicine
- Using the hemoglobin-binding Staphylococcus aureus protein IsdH to enable plasma analysis of hemolyzed blood samples
- Handling of hemolyzed serum samples in clinical chemistry laboratories: the Nordic hemolysis project
- Clinical biomarker innovation: when is it worthwhile?
- Impact of total automation consolidating first-line laboratory tests on diagnostic blood loss
- Diagnostic and prognostic value of the D-dimer test in emergency department patients: secondary analysis of an observational study
- Screening of chemical libraries in pursuit of kallikrein-5 specific inhibitors for the treatment of inflammatory dermatoses
- Comparison of five automated urine sediment analyzers with manual microscopy for accurate identification of urine sediment
- Establishment of an international autoantibody reference standard for human anti-DFS70 antibodies: proof-of-concept study for a novel Megapool strategy by pooling individual specific sera
- Only monospecific anti-DFS70 antibodies aid in the exclusion of antinuclear antibody associated rheumatic diseases: an Italian experience
- Performance evaluation of an Indoxyl Sulfate Assay Kit “NIPRO”
- Variable and inaccurate serum IgG4 levels resulting from lack of standardization in IgG subclass assay calibration
- Hematology and Coagulation
- Influence of hypertriglyceridemia, hyperbilirubinemia and hemolysis on thrombin generation in human plasma
- Reference Values and Biological Variations
- Reference intervals for serum total vitamin B12 and holotranscobalamin concentrations and their change points with methylmalonic acid concentration to assess vitamin B12 status during early and mid-pregnancy
- Cardiovascular Diseases
- Serum concentrations of free fatty acids are associated with 3-month mortality in acute heart failure patients
- Letters to the Editor
- Management of potassium results in haemolysed plasma samples at the emergency department laboratory
- Unexpected analytical interference in isavuconazole UV determination in a child in therapy with lumacaftor/ivacaftor for cystic fibrosis
- Total laboratory automation has the potential to be the field of application of artificial intelligence: the cyber-physical system and “Automation 4.0”
- 99th percentile upper reference limit of AccuTnI+3 in a Korean reference population: a multicenter study using fresh serum
- Roche Troponin T hs-STAT meets all expert opinion analytical laboratory practice recommendations for the use of the differential diagnosis of acute coronary syndrome
- A comparison of biotin interference in routine immunoassays on the Roche Cobas 8000, Beckman Coulter DXi and Siemens Advia Centaur XPT immunoassay platforms
- The importance of the methodology and sample matrix when interpreting chromogranin A results
- The sudden death of the combined first trimester aneuploidy screening, a single centre experience in Belgium
- Reply to Luksic et al. Clin Chem Lab Med 2018;56(4):574–581
Articles in the same Issue
- Frontmatter
- Editorial
- Identification and management of spurious hemolysis: controversies, concerns and criticisms
- Reviews
- CYP24A1 and SLC34A1 genetic defects associated with idiopathic infantile hypercalcemia: from genotype to phenotype
- Meta-analysis: compared with anti-CCP and rheumatoid factor, could anti-MCV be the next biomarker in the rheumatoid arthritis classification criteria?
- Opinion Paper
- Collection, transport and storage procedures for blood culture specimens in adult patients: recommendations from a board of Italian experts
- General Clinical Chemistry and Laboratory Medicine
- Using the hemoglobin-binding Staphylococcus aureus protein IsdH to enable plasma analysis of hemolyzed blood samples
- Handling of hemolyzed serum samples in clinical chemistry laboratories: the Nordic hemolysis project
- Clinical biomarker innovation: when is it worthwhile?
- Impact of total automation consolidating first-line laboratory tests on diagnostic blood loss
- Diagnostic and prognostic value of the D-dimer test in emergency department patients: secondary analysis of an observational study
- Screening of chemical libraries in pursuit of kallikrein-5 specific inhibitors for the treatment of inflammatory dermatoses
- Comparison of five automated urine sediment analyzers with manual microscopy for accurate identification of urine sediment
- Establishment of an international autoantibody reference standard for human anti-DFS70 antibodies: proof-of-concept study for a novel Megapool strategy by pooling individual specific sera
- Only monospecific anti-DFS70 antibodies aid in the exclusion of antinuclear antibody associated rheumatic diseases: an Italian experience
- Performance evaluation of an Indoxyl Sulfate Assay Kit “NIPRO”
- Variable and inaccurate serum IgG4 levels resulting from lack of standardization in IgG subclass assay calibration
- Hematology and Coagulation
- Influence of hypertriglyceridemia, hyperbilirubinemia and hemolysis on thrombin generation in human plasma
- Reference Values and Biological Variations
- Reference intervals for serum total vitamin B12 and holotranscobalamin concentrations and their change points with methylmalonic acid concentration to assess vitamin B12 status during early and mid-pregnancy
- Cardiovascular Diseases
- Serum concentrations of free fatty acids are associated with 3-month mortality in acute heart failure patients
- Letters to the Editor
- Management of potassium results in haemolysed plasma samples at the emergency department laboratory
- Unexpected analytical interference in isavuconazole UV determination in a child in therapy with lumacaftor/ivacaftor for cystic fibrosis
- Total laboratory automation has the potential to be the field of application of artificial intelligence: the cyber-physical system and “Automation 4.0”
- 99th percentile upper reference limit of AccuTnI+3 in a Korean reference population: a multicenter study using fresh serum
- Roche Troponin T hs-STAT meets all expert opinion analytical laboratory practice recommendations for the use of the differential diagnosis of acute coronary syndrome
- A comparison of biotin interference in routine immunoassays on the Roche Cobas 8000, Beckman Coulter DXi and Siemens Advia Centaur XPT immunoassay platforms
- The importance of the methodology and sample matrix when interpreting chromogranin A results
- The sudden death of the combined first trimester aneuploidy screening, a single centre experience in Belgium
- Reply to Luksic et al. Clin Chem Lab Med 2018;56(4):574–581
