scholarly journals Joint EFLM-COLABIOCLI Recommendation for venous blood sampling

2018 ◽  
Vol 56 (12) ◽  
pp. 2015-2038 ◽  
Author(s):  
Ana-Maria Simundic ◽  
Karin Bölenius ◽  
Janne Cadamuro ◽  
Stephen Church ◽  
Michael P. Cornes ◽  
...  

Abstract This document provides a joint recommendation for venous blood sampling of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for Preanalytical Phase (WG-PRE) and Latin American Working Group for Preanalytical Phase (WG-PRE-LATAM) of the Latin America Confederation of Clinical Biochemistry (COLABIOCLI). It offers guidance on the requirements for ensuring that blood collection is a safe and patient-centered procedure and provides practical guidance on how to successfully overcome potential barriers and obstacles to its widespread implementation. The target audience for this recommendation are healthcare staff members directly involved in blood collection. This recommendation applies to the use of a closed blood collection system and does not provide guidance for the blood collection with an open needle and syringe and catheter collections. Moreover, this document neither addresses patient consent, test ordering, sample handling and transport nor collection from children and unconscious patients. The recommended procedure is based on the best available evidence. Each step was graded using a system that scores the quality of the evidence and the strength of the recommendation. The process of grading was done at several face-to-face meetings involving the same mixture of stakeholders stated previously. The main parts of this recommendation are: 1) Pre-sampling procedures, 2) Sampling procedure, 3) Post-sampling procedures and 4) Implementation. A first draft of the recommendation was circulated to EFLM members for public consultation. WG-PRE-LATAM was also invited to comment the document. A revised version has been sent for voting on to all EFLM and COLABIOCLI members and has been officially endorsed by 33/40 EFLM and 21/21 COLABIOCLI members. We encourage professionals throughout Europe and Latin America to adopt and implement this recommendation to improve the quality of blood collection practices and increase patient and workers safety.

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Güzin Aykal ◽  
Hatice Esen ◽  
Cemile Öz ◽  
Ayşenur Yeğin

Summary Background Phlebotomy is one of the most important steps in the preanalytical phase of a clinical laboratory process. In order to decrease phlebotomy errors, this specific procedure should be taught in detail by laboratory organizations. Our study aims to practice the training program on venous blood sampling and observe the close follow-up results. Methods In this observational study, 127 students who started their summer internship in Antalya Education and Research Hospital were given a one-day theoretical phlebotomy training in accordance with the Venous Blood Sampling Guidelines. After the theoretical training, phlebotomy applications of 10 students who were working in the field of out-patient blood sampling were observed both with and without their knowledge. A comprehensive checklist related to phlebotomy was created by the trainers in Antalya Education and Research Hospital and the observers answered each question as yes or no. For the statistical analysis, IBM SPSS Statistics 21.0 was used. Results After the theoretical education, the trainees were observed but no significant difference was found between the first and the second informed observations (p = 0.125). The students were observed three times more in the following week without their knowledge. There was a statistically significant difference between the first and the third unannounced observations (p=0.001). Conclusions In order to perform phlebotomy correctly, apart from theoretical education, a close follow-up is necessary too.


2020 ◽  
Author(s):  
Francisco Freitas ◽  
Mónica Alves

AbstractBackgroundGuidelines for venous blood sampling procedure (phlebotomy) discourage tourniquet use whenever possible. Here, we aimed to assess the Biomedical Scientists capability of not using the tourniquet in phlebotomy, which we hypothesized to be equal to 50% of the patients attended, and identifying the most frequent venipuncture site.Materials and MethodsWe selected and assigned two (BMS) with the same age (41 years) and experience (20 years) to record ten phlebotomy days, the first with prioritized and the latter with non-prioritized patients. In a simple record form, each acquired daily data for the number of attended patients, age and gender, the frequency of non-tourniquet usage and the punctured vein. To test our work hypothesis we used the two-tailed single sample t-test (p < 0.05). Differences between age-group means and non-tourniquet use means by each BMS were tested by two-tailed t-test for independent means (p < 0.05).ResultsIn 10 phlebotomy days 683 patients were attended, with males representing 43,2% of the population. We found no statistically difference between age-group means. The combined capability of non-tourniquet use was 50,5%, which did not differ from our null hypothesis, but the individual group-means were statistically different, being 33% and 66.9% in the prioritized vs non-prioritized group. The medial cubital vein was the most prone to be punctured (77,7%).ConclusionsWe have shown that performing phlebotomies without tourniquet use is possible and desirable in at least half of the attended patients, though being more limited in specific group populations. Our results provide room for quality improvement in the laboratory pre-analytical phase.Key points summaryWe assessed the capability of Biomedical Scientists not using the tourniquet in real life blood sampling procedures for diagnostic purposes.Blood was collected from at least half of the attended patients without tourniquet use.Biomedical Scientists were able to prioritize the antecubital veins without tourniquet application (medial cubital vein the most prone to be punctured - 78% of attempts).


2015 ◽  
Vol 2 (1) ◽  
pp. 050-054
Author(s):  
Tri Winarti

Newborns in hospitals often have a variety of invasive procedures, so that the baby is experiencingpain. Baby’s sense of discomfort and fear which will result from the pain can be observed throughthe tears. While wrapping the newborn to fit in a blanket (swaddling) can soothe a fussy baby or cry. Thepurpose of this study was to identify the effect of swaddling on pain response in neonates after venousblood sampling procedures in hospitals Ngudi Waluyo Wlingi. This study was descriptive. Samplestaken by accidental sampling technique with a sample of 35 neonates. The results showed that swaddledneonates after venous blood sampling procedure was 80% (28 respondents) pulse between 120–160times per minute, 100% (35 respondents) respiration between 30–60 times per minute and 51.4% (18respondents) SaO2 is greater than 92%. Behavioral responses such as shrill and loud cry was 8.4% (24respondents), stretching in some facial muscles and facial muscles stretching along each was 4.2% (12respondents), a strong move is 5.95% (17 respondents ), and increased muscle tone face with flexion ofthe fingers and toes was 7.7% (22 respondents).Use of swaddling post venous blood sampling proceduresin neonates can be used as a way of making neonates feel comfortable and calm.


2017 ◽  
Vol 55 (1) ◽  
pp. 27-31 ◽  
Author(s):  
Michael Cornes ◽  
Edmée van Dongen-Lases ◽  
Kjell Grankvist ◽  
Mercedes Ibarz ◽  
Gunn Kristensen ◽  
...  

AbstractIt has been well reported over recent years that most errors within the total testing process occur in the pre-analytical phase (46%–68.2%), an area that is usually outside of the direct control of the laboratory and which includes sample collection (phlebotomy). National and international (WHO, CLSI) guidelines recommend that the order of draw of blood during phlebotomy should be blood culture/sterile tubes, then plain tubes/gel tubes, then tubes containing additives. This prevents contamination of sample tubes with additives from previous tubes that could cause erroneous results. There have been a number of studies recently looking at whether order of draw remains a problem with modern phlebotomy techniques and materials, or it is an outdated practice followed simply because of historical reasons. In the following article, the European Federation of Clinical Chemistry and Laboratory Medicine Working Group for the Preanalytical Phase (EFLM WG-PRE) provides an overview and summary of the literature with regards to order of draw in venous blood collection. Given the evidence presented in this article, the EFLM WG-PRE herein concludes that a significant frequency of sample contamination does occur if order of draw is not followed during blood collection and when performing venipuncture under less than ideal circumstances, thus putting patient safety at risk. Moreover, given that order of draw is not difficult to follow and knowing that ideal phlebotomy conditions and protocols are not always followed or possible, EFLM WG-PRE supports the continued recommendation of ensuring a correct order of draw for venous blood collection.


2020 ◽  
Vol 58 (10) ◽  
pp. 1655-1662
Author(s):  
Alexander von Meyer ◽  
Giuseppe Lippi ◽  
Ana-Maria Simundic ◽  
Janne Cadamuro

AbstractObjectivesAn accurate knowledge of blood collection times is crucial for verifying the stability of laboratory analytes. We therefore aimed to (i) assess if and how this information is collected throughout Europe and (ii) provide a list of potentially available solutions.MethodsA survey was issued by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group on Preanalytical Phase (WG-PRE) in 2017, aiming to collect data on preanalytical process management, including sampling time documentation, in European laboratories. A preceding pilot survey was disseminated in Austria in 2016. Additionally, preanalytical experts were surveyed on their local setting on this topic. Finally, the current scientific literature was reviewed on established possibilities of sampling time collection.ResultsA total number of 85 responses was collected from the pilot survey, whilst 1347 responses from 37 European countries were obtained from the final survey. A minority (i.e. ~13%) of responders to the latter declared they are unaware of the exact sampling time. The corresponding rate in Austria was ~70% in the pilot and ~30% in the final survey, respectively. Answers from 17 preanalytical experts from 16 countries revealed that sampling time collection seems to be better documented for out- than for in-patients. Eight different solutions for sample time documentation are presented.ConclusionsThe sample collection time seems to be documented very heterogeneously across Europe, or not at all. Here we provide some solutions to this issue and believe that laboratories should urgently aim to implement one of these.


2019 ◽  
Vol 54 (4) ◽  
pp. 291-312
Author(s):  
Ana-Maria Simundic ◽  
Karin Bölenius ◽  
Janne Cadamuro ◽  
Stephen Church ◽  
Michael P. Cornes ◽  
...  

Niniejszy dokument zawiera zalecenia dotyczące pobierania krwi żylnej, opracowane wspólnie przez European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for Preanalytical Phase (WG-PRE) oraz Latin American Working Group for Preanalytical Phase (WG-PRE-LATAM) of the Latin America Confederation of Clinical Biochemistry (COLABIOCLI). Dokument określa wytyczne dotyczące rekomendacji zapewniających bezpieczeństwo procesu pobierania krwi oraz przekazuje informacje praktyczne dotyczące skutecznego pokonywania przeszkód związanych z procesem wdrożenia procedury na szeroką skalę. Grupą docelową zaleceń są pracownicy ochrony zdrowia bezpośrednio zaangażowani w proces pobierania krwi. Zalecenia dotyczą wykorzystania zamkniętych systemów do pobierania krwi i nie znajdują zastosowania w przypadku systemów otwartych, takich jak igła ze strzykawką lub cewnik. Ponadto w dokumencie nie omówiono zagadnień związanych z uzyskaniem zgody pacjenta, zlecaniem oznaczeń, obsługą ani transportem próbki, pobieraniem krwi u dzieci i osób z utratą przytomności. Zalecana procedura powstała w oparciu o dostępne dowody naukowe. Każdy z etapów został zaszeregowany w oparciu o system, w ramach którego ocenia się zarówno jakość materiału naukowego jak i siłę zaleceń. Proces oceny przeprowadzono na drodze wielu konsultacji, w których udział brała wymieniona powyżej grupa interesariuszy. Najważniejsze aspekty niniejszych zaleceń to: 1) procedury przed pobraniem krwi, 2) procedura pobrania krwi, 3) procedury po pobraniu krwi oraz 4) wdrożenie. Wstępną wersję zaleceń przekazano członkom EFLM w ramach konsultacji publicznych. Swoje uwagi do dokumentu wnieśli również członkowie WG-PRE-LATAM. Poprawioną wersję przesłano do głosowania wszystkich członków EFLM i COLABIOCLI. Uzyskała ona poparcie 33/40 członków ELFM i 21/21 członków COLABIOCLI. Zachęcamy specjalistów z Europy i Ameryki Łacińskiej do wdrożenia niniejszych rekomendacji w celu poprawy jakości praktyk związanych z pobieraniem krwi oraz poprawy bezpieczeństwa pacjentów i pracowników ochrony zdrowia.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 275-276
Author(s):  
Jose Aravena ◽  
Jean Gajardo ◽  
Laura Gitlin

Abstract In a scenario of increasing longevity and social inequalities, Latin-America is an important contributor to the worldwide dementia burden. Caregivers’ health is fundamental to maintain the person with dementia quality of life. However, caregiving is a culturally sensible role that requires tailored solutions. The aim is to synthesize the evidence about non-pharmacologic interventions targeted to caregivers of people with dementia in Latin-American contexts. A comprehensive review of interventions in caregivers and persons with dementia in Latin-American countries was conducted using MEDLINE, Embase, PsycINFO, and Scopus with studies published until January 27th, 2020. Randomized clinical trials of non-pharmacologic interventions targeted to caregivers of people with dementia or dyads where included. Qualitative synthesis of the evidence was presented and analyzed. Overall, 9 pilot RCT were included for the final analysis (6 Brazil, 1 Colombia, 1 Mexico, 1 Perú). The biggest study recruited 69 caregivers and the smallest 13 dyads, with follow-up range of 3-6 months. 5 control groups received at least some other non-standard care type of intervention. 8 were targeted exclusively to caregivers (4 group intervention, 3 individual, and 1 combined) and 1 multicomponent intervention. Most frequent measured outcomes were caregiver’s burden, anxiety, depressive symptoms, and quality of life, and person with dementia neuropsychiatric symptoms. Individual interventions report better results in caregiver parameters such as burden and depressive symptoms and person with dementia neuropsychiatric symptoms. Group interventions presented mixed results. Nevertheless, the quality of evidence was low. There is a critical need to study interventions for caregivers in Latin-American contexts.


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