丹麦医疗保健系统临床生物化学部门静脉血采样的采血顺序规范。

Order of draw practices in venous blood sampling at clinical biochemistry departments in the Danish health care system.

作者信息

Jacobsen Katja Kemp, Brandt Ida, Christensen Anne Vindahl, Rimsø Bjørk Anine, Krøier Camilla Julie, Sørensen Michelle, Smith Julie, Jensen Kathrine Overgaard Foss, Larsen Jeppe Madura

机构信息

Department of Technology, Faculty of Health and Technology, University College Copenhagen, Copenhagen, Denmark.

出版信息

Clin Biochem. 2018 Jun;56:113-116. doi: 10.1016/j.clinbiochem.2018.04.020. Epub 2018 Apr 21.

DOI:10.1016/j.clinbiochem.2018.04.020

PMID:29684368

Abstract

BACKGROUND

Deviation in blood collection procedures is a central source of preanalytical variation affecting overall analytical and diagnostic precision. The order of draw of venous sampling is suspected to affect analytical results, in particular for coagulation analysis. Here we compare the procedures in venous blood sampling among clinical biochemistry departments to assess the uniformity of order of blood draw and adherence to international guidelines in the Danish health care system.

METHODS

We collected venous order of draw procedures from 49 clinical biochemistry departments at 22 public hospitals in Denmark. Procedures were compared to the international guidelines fromthe Clinical Laboratory Standards Institute (CLSI) and World Health Organization (WHO), and assessed in relation to department ISO 15189:2012 accreditation.

RESULTS

We observed seven different order of draw procedures related to citrate, serum, heparin, and EDTA tubes, and the use of discard tubes in relation to coagulation assays. 31 departments (63.3%) were found to adhere to CLSI and WHO guidelines. A majority of departments instructs the use of discard tubes before collection for coagulation assays in citrate tubes (44 departments; 89.8%). The citrate tube was the first sample tube to be drawn for most departments (35 departments; 75.5%); and the preferred order of non-citrate tubes was serum-heparin-EDTA (36 departments; 73.5%). Adherence to the CLSI and WHO guidelines was not associated with department ISO 15189:2012 accreditation (p = .57).

CONCLUSIONS

Venous order of draw procedures is diverse at Danish clinical biochemistry departments and show moderate adherence to international guidelines.

摘要

背景

采血程序偏差是影响整体分析和诊断精度的分析前变异的主要来源。静脉采样的采血顺序被怀疑会影响分析结果，尤其是在凝血分析方面。在此，我们比较了临床生物化学部门之间静脉采血的程序，以评估丹麦医疗保健系统中采血顺序的一致性以及对国际指南的遵循情况。

方法

我们收集了丹麦22家公立医院49个临床生物化学部门的静脉采血顺序程序。将这些程序与临床实验室标准协会（CLSI）和世界卫生组织（WHO）的国际指南进行比较，并根据部门的ISO 15189:2012认可情况进行评估。

结果

我们观察到与柠檬酸盐、血清、肝素和乙二胺四乙酸（EDTA）管相关的七种不同采血顺序程序，以及在凝血检测中废弃管的使用情况。发现31个部门（63.3%）遵循CLSI和WHO指南。大多数部门指示在使用柠檬酸盐管进行凝血检测前先采集废弃管（44个部门；89.8%）。对于大多数部门（35个部门；75.5%）来说，柠檬酸盐管是第一个采集的样本管；非柠檬酸盐管的首选顺序是血清-肝素-EDTA（36个部门；73.5%）。遵循CLSI和WHO指南与部门的ISO 15189:2012认可情况无关（p = 0.57）。