Emergency Medical Services Blood Specimen Quality versus Emergency Department Staffs

2.50
Hdl Handle:
http://hdl.handle.net/10755/162498
Type:
Presentation
Title:
Emergency Medical Services Blood Specimen Quality versus Emergency Department Staffs
Abstract:
Emergency Medical Services Blood Specimen Quality versus Emergency Department Staffs
Conference Sponsor:Emergency Nurses Association
Conference Year:2009
Author:Harrison, Gina, RN, BS, CEN
P.I. Institution Name:Inova Loudoun Hospital
Title:Management Coordinator Emergency Dept.
Contact Address:44045 Riverside Parkway, Leesburg, VA, 20176
Contact Telephone:703-858-6048
Co-Authors:Karen Gabel Speroni, RN, PhD; Lisa Dugan, RN MSN, CAN, BC; and Marlon Daniel, BS, MPH, MHA
[Leadership Conference Poster Presentation] Purpose: The practice of Emergency Departments (ED) accepting blood specimens drawn by Emergency Medical Services (EMS) staff is not consistent amongst EDs and the literature does not provide evidence to support or not support acceptance of EMS specimens. Therefore, a research study was conducted to compare differences in specimen redraw rates and ED throughput time between specimens drawn by EMS versus ED staff. From an evidence based practice perspective, results of this study can be used to delineate standard practice regarding acceptance by EDs of EMS blood specimens drawn in the field.

Design: In this prospective, observational study conducted over a 10 month period in 2007, a total of 400 patients meeting eligibility criteria were classified into one of two groups (200 per group). Group 1 (EMS) patients arrived in the ED via ambulance with blood specimens drawn in the field by EMS staff. Group 1 patients met standing intravenous (IV) protocols. Group 2 (ED) patients arrived via EMS without blood specimens but required them upon arrival to the ED. Group 2 patients had a physician order for IV and blood specimens. Registered Nurses obtained the blood specimens from Group 2 patients in the ED.

Setting: This study was conducted in a 155-bed acute-care non teaching hospital with 29-bed ED located in a suburban/rural setting in close proximity to Washington, D.C.

Subjects: All subjects in this study were greater than or equal to 18 years of age, arrived via EMS for admission to the ED, and required IV access and blood sampling.

Methods: Data collected by nurse researchers on study parameters included the following: Phlebotomist type; IV site; IV angiocatheter size; number of IV attempts; reason specimen not drawn by EMS; reason EMS drawn specimens were discarded; reason for redraw; undue blood exposure to staff; admit and discharge diagnosis, and length of ED stay.

Results: Data from 400 blood specimens (EMS group=200; ED group=200) were analyzed. Overall, the specimen redraw rate was higher for the ED group (11.5% versus 9.5%). Specimen redraws due to hemolysis were higher in the ED group (52.2%) than in the EMS group (31.6%). The primary reason for redraw was hemolysis in the ED group (52.2%) and insufficient quantity (52.6%, p<0.05) in the EMS group. Median ED throughput time was 17 minutes less for the EMS group (163 minutes) than for ED group (180 minutes) (p=0.1470). There were no blood exposure incidences in either group.

Recommendations: EDs can adopt as standard practice acceptance of blood specimens drawn by EMS staff based upon no higher specimen redraw rate and a decreased ED throughput time for patients with blood specimens having been drawn by EMS upon arrival to the ED. Although not a statistically significant finding, 17 fewer minutes may be clinically relevant in the treatment of a critically ill emergency patient, or in resource allocation and bed space in a busy emergency department. To decrease the incidence of insufficient quantity of blood specimens for EMS blood specimens, availability and use of microtainers on ambulances should be considered.
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.titleEmergency Medical Services Blood Specimen Quality versus Emergency Department Staffsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162498-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Emergency Medical Services Blood Specimen Quality versus Emergency Department Staffs</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">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Harrison, Gina, RN, BS, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Inova Loudoun Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Management Coordinator Emergency Dept.</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">44045 Riverside Parkway, Leesburg, VA, 20176</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">703-858-6048</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">gina.harrison@inova.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Karen Gabel Speroni, RN, PhD; Lisa Dugan, RN MSN, CAN, BC; and Marlon Daniel, BS, MPH, MHA</td></tr><tr><td colspan="2" class="item-abstract">[Leadership Conference Poster Presentation] Purpose: The practice of Emergency Departments (ED) accepting blood specimens drawn by Emergency Medical Services (EMS) staff is not consistent amongst EDs and the literature does not provide evidence to support or not support acceptance of EMS specimens. Therefore, a research study was conducted to compare differences in specimen redraw rates and ED throughput time between specimens drawn by EMS versus ED staff. From an evidence based practice perspective, results of this study can be used to delineate standard practice regarding acceptance by EDs of EMS blood specimens drawn in the field. <br/><br/>Design: In this prospective, observational study conducted over a 10 month period in 2007, a total of 400 patients meeting eligibility criteria were classified into one of two groups (200 per group). Group 1 (EMS) patients arrived in the ED via ambulance with blood specimens drawn in the field by EMS staff. Group 1 patients met standing intravenous (IV) protocols. Group 2 (ED) patients arrived via EMS without blood specimens but required them upon arrival to the ED. Group 2 patients had a physician order for IV and blood specimens. Registered Nurses obtained the blood specimens from Group 2 patients in the ED. <br/><br/>Setting: This study was conducted in a 155-bed acute-care non teaching hospital with 29-bed ED located in a suburban/rural setting in close proximity to Washington, D.C.<br/><br/>Subjects: All subjects in this study were greater than or equal to 18 years of age, arrived via EMS for admission to the ED, and required IV access and blood sampling. <br/><br/>Methods: Data collected by nurse researchers on study parameters included the following: Phlebotomist type; IV site; IV angiocatheter size; number of IV attempts; reason specimen not drawn by EMS; reason EMS drawn specimens were discarded; reason for redraw; undue blood exposure to staff; admit and discharge diagnosis, and length of ED stay. <br/><br/>Results: Data from 400 blood specimens (EMS group=200; ED group=200) were analyzed. Overall, the specimen redraw rate was higher for the ED group (11.5% versus 9.5%). Specimen redraws due to hemolysis were higher in the ED group (52.2%) than in the EMS group (31.6%). The primary reason for redraw was hemolysis in the ED group (52.2%) and insufficient quantity (52.6%, p&lt;0.05) in the EMS group. Median ED throughput time was 17 minutes less for the EMS group (163 minutes) than for ED group (180 minutes) (p=0.1470). There were no blood exposure incidences in either group. <br/><br/>Recommendations: EDs can adopt as standard practice acceptance of blood specimens drawn by EMS staff based upon no higher specimen redraw rate and a decreased ED throughput time for patients with blood specimens having been drawn by EMS upon arrival to the ED. Although not a statistically significant finding, 17 fewer minutes may be clinically relevant in the treatment of a critically ill emergency patient, or in resource allocation and bed space in a busy emergency department. To decrease the incidence of insufficient quantity of blood specimens for EMS blood specimens, availability and use of microtainers on ambulances should be considered.</td></tr></table>en_GB
dc.date.available2011-10-27T10:29:13Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:29:13Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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