Matteo Masotto1, Rinaldo Brivio2, Giovanni De Vito3, Candida Ester Villa4, Davide Ausili5. 1. Infermiere Libero Professionista, Servizio di Assistenza Domiciliare Integrata, Monza e Brianza. 2. Medico, Laboratorio Analisi, A.O. San Gerardo, Monza. 3. Medico, Medicina del Lavoro, A.O. Provincia di Lecco, Lecco. 4. Coordinatore Didattico, Corso di Laurea in Infermieristica (Sede di Monza), Università di Milano-Bicocca, Monza. 5. PhD. Assegnista di ricerca in Scienze Infermieristiche, Dipart. Scienze Salute, Università di Milano-Bicocca, Monza Per corrispondenza: Matteo Masotto, matteo.maso@tiscali.it.
Abstract
INTRODUCTION: Around 60-70% of diagnostic and therapeutic decisions are based on blood exams. Several errors occur during the pre-analytic phase. AIMS: of this study were: to describe nurses' behaviours in blood specimen collection; to describe prevalence and type of pre-analytical errors; to assess the association between pre-analytical errors and occurrence of unsuitable specimens. METHODS: An observational cross-sectional study was conducted by means of a structured form based on up-to-date clinical recommendations. A researcher observed nurses' behaviors during 172 blood sampling procedures in medical, surgical and emergency care settings. Unsuitable procedures were registered. RESULTS: Most behaviours were correct, however some significantly diverged from recommended practices: active and passive patient identification; respect of antiseptic solution's drying time; rapid removal of tourniquet when blood started flowing. The prevalence of unsuitable specimen reports was significantly higher when the procedure involved a small calibre vein (RP: 0.19; IC95% 0.04 - 0.98; p = 0.03) and when blood drawing was difficult (RP; 3.83; IC95% 1.63 - 9.01; p <0.001). CONCLUSIONS: The pre-analytical phase is important for the diagnostic process and safety of patients. Although some factors – as patients' characteristics – are non-modifiable, some nurses' behaviours could be improved to reduce risk of pre-analytical errors. Further studies are needed to clarify the associations between pre-analytical errors and laboratory outcomes.
INTRODUCTION: Around 60-70% of diagnostic and therapeutic decisions are based on blood exams. Several errors occur during the pre-analytic phase. AIMS: of this study were: to describe nurses' behaviours in blood specimen collection; to describe prevalence and type of pre-analytical errors; to assess the association between pre-analytical errors and occurrence of unsuitable specimens. METHODS: An observational cross-sectional study was conducted by means of a structured form based on up-to-date clinical recommendations. A researcher observed nurses' behaviors during 172 blood sampling procedures in medical, surgical and emergency care settings. Unsuitable procedures were registered. RESULTS: Most behaviours were correct, however some significantly diverged from recommended practices: active and passive patient identification; respect of antiseptic solution's drying time; rapid removal of tourniquet when blood started flowing. The prevalence of unsuitable specimen reports was significantly higher when the procedure involved a small calibre vein (RP: 0.19; IC95% 0.04 - 0.98; p = 0.03) and when blood drawing was difficult (RP; 3.83; IC95% 1.63 - 9.01; p <0.001). CONCLUSIONS: The pre-analytical phase is important for the diagnostic process and safety of patients. Although some factors – as patients' characteristics – are non-modifiable, some nurses' behaviours could be improved to reduce risk of pre-analytical errors. Further studies are needed to clarify the associations between pre-analytical errors and laboratory outcomes.
Authors: G Troiano; N Nante; A Fanelli; G M Rossolini; P Pecile; P Bordonaro; B Peruzzi; M Lo Rubbio; T Tanini; C Duranti; G Piccinno; F Niccolini Journal: J Prev Med Hyg Date: 2020-04-02