The Effect of Blood Drawing Techniques and Equipment of the Hemolysis of ED Laboratory Blood Samples

2.50
Hdl Handle:
http://hdl.handle.net/10755/162868
Type:
Presentation
Title:
The Effect of Blood Drawing Techniques and Equipment of the Hemolysis of ED Laboratory Blood Samples
Abstract:
The Effect of Blood Drawing Techniques and Equipment of the Hemolysis of ED Laboratory Blood Samples
Conference Sponsor:Emergency Nurses Association
Conference Year:2003
Author:Grant, Marian S., BSN, RN
P.I. Institution Name:Johns Hopkins Hospital
Contact Address:Adult ED, 600 N. Wolfe Street, Baltimore, MD, 21287, USA
Contact Telephone:(410) 955-2280
Purpose: To identify blood draw factors associated with hemolysis (red-blood-cell damage) of emergency department blood samples. Hemolysis can cause inaccurate results or, if results are cancelled, delays in patient treatment plans and increased staff workload due to a second blood draw. Design/Setting: The study was a prospective descriptive comparative design in a teaching, urban Level I trauma center. Sample: A convenience sample was used consisting of all blood draws done during the 19 day study period. Methodology: Blood samples were examined for degree of hemolysis and blood draw factors using data obtained from the reporting survey completed by emergency nurses and/or ED clinical technicians. The survey was developed by the investigator and reviewed by ED staff and the nurse manager for content validity. It included the venipuncture technique, the blood-drawing sequence, the equipment and needle types/sizes used for each blood sample sent to the laboratory for diagnostic testing. The level of hemolysis per sample was designated by lab technicians, as is the standard of care. Completed questionnaires were gathered and analyzed. Chi-square analysis was used to determine significant relationships. Results: 598 surveys were collected and 76% (n=454) were complete enough to be analyzed. The predominant technique for drawing blood in new venipunctures (n=372) was by intravenous catheters, 69% (n=255), versus straight needles, 31% (n=117). Thirty-two percent of the samples had some degree of hemolysis, 13% were so hemolyzed that tests were cancelled by the lab. Blood drawn through intravenous catheters resulted in significantly more hemolysis than those drawn with a straight needle (20% versus <1%, significant at p<0.001). Intravenous catheter hemolysis was higher when a Vacutainer(R) was used versus a syringe (22% test cancelled versus 9% cancelled, significant at p=0.02). No differences in hemolysis were noted among individual phlebotomists or lab technicians, or when factoring in the size of intravenous catheter, needle, or syringe. Conclusion: Drawing blood with straight needles was associated with significantly less hemolysis than drawing blood through intravenous catheters. Using the combination of intravenous catheters and syringes resulted in less hemolysis than using intravenous catheters with Vacutainers(R). Changing these nursing practices can reduce hemolysis and thereby improve patient care and staff efficiency. [Research Presentation]
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.titleThe Effect of Blood Drawing Techniques and Equipment of the Hemolysis of ED Laboratory Blood Samplesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162868-
dc.description.abstract<table><tr><td colspan="2" class="item-title">The Effect of Blood Drawing Techniques and Equipment of the Hemolysis of ED Laboratory Blood Samples</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">2003</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Grant, Marian S., BSN, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Johns Hopkins Hospital</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Adult ED, 600 N. Wolfe Street, Baltimore, MD, 21287, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(410) 955-2280</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">msgrant@comcast.net</td></tr><tr><td colspan="2" class="item-abstract">Purpose: To identify blood draw factors associated with hemolysis (red-blood-cell damage) of emergency department blood samples. Hemolysis can cause inaccurate results or, if results are cancelled, delays in patient treatment plans and increased staff workload due to a second blood draw. Design/Setting: The study was a prospective descriptive comparative design in a teaching, urban Level I trauma center. Sample: A convenience sample was used consisting of all blood draws done during the 19 day study period. Methodology: Blood samples were examined for degree of hemolysis and blood draw factors using data obtained from the reporting survey completed by emergency nurses and/or ED clinical technicians. The survey was developed by the investigator and reviewed by ED staff and the nurse manager for content validity. It included the venipuncture technique, the blood-drawing sequence, the equipment and needle types/sizes used for each blood sample sent to the laboratory for diagnostic testing. The level of hemolysis per sample was designated by lab technicians, as is the standard of care. Completed questionnaires were gathered and analyzed. Chi-square analysis was used to determine significant relationships. Results: 598 surveys were collected and 76% (n=454) were complete enough to be analyzed. The predominant technique for drawing blood in new venipunctures (n=372) was by intravenous catheters, 69% (n=255), versus straight needles, 31% (n=117). Thirty-two percent of the samples had some degree of hemolysis, 13% were so hemolyzed that tests were cancelled by the lab. Blood drawn through intravenous catheters resulted in significantly more hemolysis than those drawn with a straight needle (20% versus &lt;1%, significant at p&lt;0.001). Intravenous catheter hemolysis was higher when a Vacutainer(R) was used versus a syringe (22% test cancelled versus 9% cancelled, significant at p=0.02). No differences in hemolysis were noted among individual phlebotomists or lab technicians, or when factoring in the size of intravenous catheter, needle, or syringe. Conclusion: Drawing blood with straight needles was associated with significantly less hemolysis than drawing blood through intravenous catheters. Using the combination of intravenous catheters and syringes resulted in less hemolysis than using intravenous catheters with Vacutainers(R). Changing these nursing practices can reduce hemolysis and thereby improve patient care and staff efficiency. [Research Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:35:31Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:35:31Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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