2.50
Hdl Handle:
http://hdl.handle.net/10755/162395
Type:
Presentation
Title:
Be Advised Before It's Hemolyzed
Abstract:
Be Advised Before It's Hemolyzed
Conference Sponsor:Emergency Nurses Association
Conference Year:2010
Author:Mittas, Lisa, RN, BSN, CEN
P.I. Institution Name:Aultman Hospital
Title:ED Educator
Contact Address:2600 6th Street SW, Canton, OH, 44710, USA
Contact Telephone:330-363-5846
Co-Authors:Elizabeth Good, RN, MSN
[ENA Annual Conference - Evidence-based Practice Presentation]

Purpose: The Emergency Department (ED) noted an increased incidence of hemolyzed blood specimens each month. The department was first alerted of this issue upon review of data which showed that 6.8% of stroke lab specimens drawn in the ED were hemolyzed. This delayed important tests results that were needed in order to proceed with the administration of tPA. Our goal was to reduce the number of hemolyzed specimens each month through education and the use of pocket reference cards.

Design: This is a quality assurance project. By using a process that decreases hemolyzed blood specimens, both quality of care and patient satisfaction improve.

Setting: This project takes place in an urban, level 2 trauma center.

Participants/Subjects: The ED Shared Decision-Making (SDM) Council identified the initial problem. The ED educator then focused on the process of gathering data and information and creating educational materials. The educator then provided education to the staff (RNs, Paramedics, and Clinical Technicians).

Method: Hemolyzed specimens create issues for the patient, RN, MD and lab technicians. Information was gathered on the number of hemolyzed specimens starting in July and education was completed in August. A review of the literature did not result in any new knowledge regarding hemolysis. After consulting with the laboratory supply representative on hemolysis prevention, preshift education sessions entitled "Hop on the ER Express Train-8 Minutes or Less" were utilized. This provided education to all staff on the topics of lab draws and hemolysis of specimens. Monthly reports of hemolyzed specimens were reviewed by the ED Educator, who became the champion for the project. The blood draw process was reviewed and staff was educated on troubleshooting hemolysis and the proper sequence of tubes to use for a blood draw. Staff was encouraged to incorporate the teachings into their care at the bedside. Monthly hemolysis reports were maintained and reviewed by total number per team, and census variables.

Results/Outcomes: From July 2009 through December 2009, the rate of hemolyzed specimens decreased by 22 %. A spike was noted in the incidence of hemolysis for one month, but with re-education and reminders, this has gone down again. In addition, Press Ganey patient satisfaction scores under the "Test" category increased from a mean score of 89.5 in July to 93.8 in December. Hemolyzed lab specimens for ED stroke patients also decreased from 6.9% in 2008 to 1.8% in 2009.

Implications: Through implementation of focused staff education, hemolysis rates for lab specimens decreased throughout the ED. While the main focus was to reduce hemolysis rates, the department also experienced an added benefit of an increase in patient satisfaction scores. In the inpatient setting, patients receive services from departments that require specific training (i.e., phlebotomy is completed by trained phlebotomists). Often the ED staff learns the basics in order to provide these same services to ED patients, but often lack the specified training required to troubleshoot issues such as avoiding hemolysis. Providing this education may help in improving clinical outcomes.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleBe Advised Before It's Hemolyzeden_GB
dc.identifier.urihttp://hdl.handle.net/10755/162395-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Be Advised Before It's Hemolyzed</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Mittas, Lisa, RN, BSN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Aultman Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">ED Educator</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">2600 6th Street SW, Canton, OH, 44710, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">330-363-5846</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Lmittas@aultman.com</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Elizabeth Good, RN, MSN</td></tr><tr><td colspan="2" class="item-abstract">[ENA Annual Conference - Evidence-based Practice Presentation] <br/><br/>Purpose: The Emergency Department (ED) noted an increased incidence of hemolyzed blood specimens each month. The department was first alerted of this issue upon review of data which showed that 6.8% of stroke lab specimens drawn in the ED were hemolyzed. This delayed important tests results that were needed in order to proceed with the administration of tPA. Our goal was to reduce the number of hemolyzed specimens each month through education and the use of pocket reference cards.<br/><br/>Design: This is a quality assurance project. By using a process that decreases hemolyzed blood specimens, both quality of care and patient satisfaction improve.<br/><br/>Setting: This project takes place in an urban, level 2 trauma center.<br/><br/>Participants/Subjects: The ED Shared Decision-Making (SDM) Council identified the initial problem. The ED educator then focused on the process of gathering data and information and creating educational materials. The educator then provided education to the staff (RNs, Paramedics, and Clinical Technicians). <br/><br/>Method: Hemolyzed specimens create issues for the patient, RN, MD and lab technicians. Information was gathered on the number of hemolyzed specimens starting in July and education was completed in August. A review of the literature did not result in any new knowledge regarding hemolysis. After consulting with the laboratory supply representative on hemolysis prevention, preshift education sessions entitled &quot;Hop on the ER Express Train-8 Minutes or Less&quot; were utilized. This provided education to all staff on the topics of lab draws and hemolysis of specimens. Monthly reports of hemolyzed specimens were reviewed by the ED Educator, who became the champion for the project. The blood draw process was reviewed and staff was educated on troubleshooting hemolysis and the proper sequence of tubes to use for a blood draw. Staff was encouraged to incorporate the teachings into their care at the bedside. Monthly hemolysis reports were maintained and reviewed by total number per team, and census variables.<br/><br/>Results/Outcomes: From July 2009 through December 2009, the rate of hemolyzed specimens decreased by 22 %. A spike was noted in the incidence of hemolysis for one month, but with re-education and reminders, this has gone down again. In addition, Press Ganey patient satisfaction scores under the &quot;Test&quot; category increased from a mean score of 89.5 in July to 93.8 in December. Hemolyzed lab specimens for ED stroke patients also decreased from 6.9% in 2008 to 1.8% in 2009. <br/><br/>Implications: Through implementation of focused staff education, hemolysis rates for lab specimens decreased throughout the ED. While the main focus was to reduce hemolysis rates, the department also experienced an added benefit of an increase in patient satisfaction scores. In the inpatient setting, patients receive services from departments that require specific training (i.e., phlebotomy is completed by trained phlebotomists). Often the ED staff learns the basics in order to provide these same services to ED patients, but often lack the specified training required to troubleshoot issues such as avoiding hemolysis. Providing this education may help in improving clinical outcomes. <br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:27:28Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:27:28Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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