Melkie Mulugeta, Girma Abel, Tsalla Tsegaye
Department of Medical Laboratory Science, Arbaminch University, Arba Minch, Ethiopia.
BMC Health Serv Res. 2014 Feb 25;14:88. doi: 10.1186/1472-6963-14-88.
Pre-analytical phase of overall laboratory testing system continues to be the major source of errors that affect patient safety and health care system. One of the activities in this phase is venous blood collection (VBC), the most common type of specimen drawn or sent to clinical laboratories for further analysis; and the source for a potentially numerous types of errors. In this study, we focused on determining and comparing desirability/undesirability of activities during VBC in Ethiopian hospitals among different groups of professionals.
We conducted a cross-sectional comparative study in three government hospitals in South Ethiopia from February 2012 to September 2012. Randomly selected professionals who participate in VBC in outpatient and inpatient departments were requested to fill in structured and pretested questionnaire regarding their practice of VBC and their replies were categorized as 'desirable' and 'undesirable' according to Clinical and Laboratory Standards Institute (CLSI) standard. Then, data was analyzed using Medcalc® version 12.1.4 software. P value of less than 0.05 was considered as statistically significant.
In our study, 120 professionals were included among which 15.8% (n = 19) were laboratory professionals while the remaining 84.2% (n = 101) were non-laboratory professionals. Conscious patient identification in pre-collection phase of VBC and position of patients' hands in actual collection phase of VBC involved the highest proportion of undesirability among both groups of professionals. However, in the post collection phase, specimen transferring from syringes to test tubes (15.8%) and mixing specimen with additives (63.4%) involved highest proportions of undesirability among laboratory and non-laboratory professionals respectively. Laboratory professionals reported better desirable practice in patient identification frequency, labeling and checking expiry dates of test tubes, specimen transfer and transport practices.
In conclusion, preparatory activities of VBC involved the highest proportions of undesirable practices among both groups of professionals. However, relatively better proportions of desirability were seen among laboratory professionals than non-laboratory professionals in some pre- and post-collection phase activities. The difference might be seen as a result of better qualification, education and training experience on VBC among laboratory professionals.
整个实验室检测系统的分析前阶段仍然是影响患者安全和医疗保健系统的主要误差来源。此阶段的一项活动是静脉血采集（VBC），这是采集或送往临床实验室进行进一步分析的最常见标本类型，也是潜在多种误差的来源。在本研究中，我们专注于确定和比较埃塞俄比亚医院不同专业人员群体在VBC过程中各项活动的可取性/不可取性。
2012年2月至2012年9月，我们在埃塞俄比亚南部的三家政府医院进行了一项横断面比较研究。要求在门诊和住院部参与VBC的随机选择的专业人员填写有关其VBC操作的结构化且经过预测试的问卷，并根据临床和实验室标准协会（CLSI）标准将他们的回答分为“可取”和“不可取”。然后，使用Medcalc® 12.1.4版软件进行数据分析。P值小于0.05被认为具有统计学意义。
在我们的研究中，纳入了120名专业人员，其中15.8%（n = 19）是实验室专业人员，其余84.2%（n = 101）是非实验室专业人员。VBC采集前阶段对患者的清醒识别以及VBC实际采集阶段患者手部的位置在两组专业人员中不可取比例最高。然而，在采集后阶段，实验室专业人员中标本从注射器转移到试管（15.8%）不可取比例最高，而非实验室专业人员中标本与添加剂混合（63.4%）不可取比例最高。实验室专业人员在患者识别频率、试管标签和有效期检查、标本转移和运输操作方面报告了更好的可取做法。
总之，VBC的准备活动在两组专业人员中不可取做法比例最高。然而，在一些采集前和采集后阶段活动中，实验室专业人员的可取比例相对高于非实验室专业人员。这种差异可能是由于实验室专业人员在VBC方面有更好的资质、教育和培训经验所致。
