Bölenius Karin, Brulin Christine, Graneheim Ulla H
Department of Nursing, Umeå University, 901 87 Umeå, Sweden.
Nurs Res Pract. 2014;2014:538704. doi: 10.1155/2014/538704. Epub 2014 Oct 30.
Background. Blood specimen collection is a common procedure in health care, and the results from specimen analysis have essential influence on clinical decisions. Errors in phlebotomy may lead to repeated sampling and delay in diagnosis and may jeopardise patient safety. This study aimed to describe the experiences of, and reflections on, phlebotomy practices of phlebotomy personnel working in primary health care after participating in an educational intervention programme (EIP). Methods. Thirty phlebotomists from ten primary health care centres participated. Their experiences were investigated through face-to-face interviews. Findings were analysed using qualitative content analysis. Results. The participants perceived the EIP as having opened up opportunities to reflect on safety. The EIP had made them aware of risks in relation to identification procedures, distractions from the environment, lack of knowledge, and transfer of information. The EIP also resulted in improvements in clinical practice, such as a standardised way of working and increased accuracy. Some said that the training had reassured them to continue working as usual, while others continued as usual regardless of incorrect procedure. Conclusions. The findings show that EIP can stimulate reflections on phlebotomy practices in larger study groups. Increased knowledge of phlebotomy practices improves the opportunities to revise and maximise the quality and content of future EIPs. Educators and safety managers should reflect on and pay particular attention to the identification procedure, distractions from the environment, and transfer of information, when developing and implementing EIPs. The focus of phlebotomy training should not solely be on improving adherence to practice guidelines.
背景。血液标本采集是医疗保健中的常见操作，标本分析结果对临床决策具有至关重要的影响。静脉穿刺错误可能导致重复采样和诊断延迟，并可能危及患者安全。本研究旨在描述参与教育干预计划（EIP）后，基层医疗保健机构中静脉穿刺人员的静脉穿刺实践经验及思考。方法。来自十个基层医疗保健中心的30名静脉穿刺师参与了研究。通过面对面访谈调查他们的经验。采用定性内容分析法对研究结果进行分析。结果。参与者认为EIP为反思安全性提供了机会。EIP使他们意识到与识别程序、环境干扰、知识缺乏和信息传递相关的风险。EIP还带来了临床实践方面的改进，例如标准化的工作方式和更高的准确性。一些人表示培训让他们放心可以继续照常工作，而另一些人则不顾操作程序是否正确继续照常工作。结论。研究结果表明，EIP可以促使更大规模研究群体对静脉穿刺实践进行反思。增加对静脉穿刺实践的了解，有助于提高修订和优化未来EIP质量及内容的机会。教育工作者和安全管理人员在制定和实施EIP时，应反思并特别关注识别程序、环境干扰和信息传递。静脉穿刺培训的重点不应仅仅是提高对实践指南的依从性。
