The promotion of ideal phlebotomy practices and sample transport procedures is a pre-requisite for the efficacy of laboratory functioning. This indicates that blood has accumulated in the tissue surrounding the vein. Sources of error in venipuncture procedure include failure to mix blood collected in additive-containing tubes immediately An incubator temperature should be set at The antiseptic most commonly used for blood collection is Microorganisms likely to cause disease are those that thrive at temperatures between 96°F and 101°F Bacteria Philadelphia, PA: Lippincott, Williams and Wilkins, 2008:245. The blood is normally drawn from a vein on the top of the hand or from the inside of the elbow. The magnitude of these errors in terms of best use of healthcare re-sources and potential for patient harm is applicable in all labora- Have patient clench fist. Venipuncture is most often done for laboratory testing. In the present study, the preanalytical errors compound to about 0.38% (1802 samples) which is low. Medication errors due to contamination. In most circles, the terms venipuncture and phlebotomy are used interchangeably. Outpatient: 0.35%. The majority of errors in specimen labeling typically occur as failures in workflow or process rather than as failures to have delineated specimen labeling policies or procedures. McCall R, Tankersley C. Phlebotomy Essentials. hub. However, sources of error common causes of false positive and negative reactions in both dat and iat are shown: false positive mechanism cold autoantibody in vitro complement fixation and auto agglutination technical dirty tubes colloidal silica anti-species antibody heterologous antibody in the antiglobulin reagent polyagglutinable red cells presence of … For certain chemistry analytes, such as glucose and cholesterol, patients need to be fasting (absence of food and liquids) for at least 12 hours prior to veni-puncture. Collection of Diagnostic Venous Blood Specimens is the long-awaited 7th edition of the CLSI venipuncture standard. 5th ed. A checklist was used to collect data on the phlebotomy procedure and errors. b. Wash hands, tie tourniquet 3-4 inches above site (If it rolls up, it's too tight!) SOURCES OF ERROR IN SPECIMEN COLLECTION, TRANSPORT PROCESSING AND STORAGE 5 1. ); Patients are often not conscious nor contactable; Results are needed in short time; Operators are working under stress. a butterfly collection system is also called a (n)______ infusion set. Topics include: venipuncture procedure and safety, advanced techniques in blood collection, blood collection equipment and modern safety devices and equipment. Sources of error in venipuncture preparation include: 1. improper patient identification 2.Failure to check patient adherence to dietary restrictions 3.. Use of improper equipment and supplies 4. This list summarizes the errors we will be exploring in this article: 1. However, in human medicine, immunoassays remain a prime . The focus of this article will be those errors that occur during the actual performance of the venipuncture or skin puncture until the specimen is obtained. Söderberg J, Brulin C, Grankvist K, Wallin O. Preanalytical errors in primary healthcare: a questionnaire study of information search procedures, test request management and test tube labelling. Basic Phlebotomy: This section covers the laboratory environment, anatomy, safety and infection control, phlebotomy equipment, and the phlebotomy procedure. Safety in the Lab and Phlebotomy environment: 2 • Demonstrate and practice techniques to safely . Ask the patient to lie on his/her back in a comfortable position. These include collection of samples, transportation, storage, and methodology used as well as intercurrent issues of the patients. Learn. Education and National Certifications • Students should have or be pursuing a high school diploma or GED. To minimize anxiety and divert attention before a phlebotomy procedure, the medical assistant should first: a. Other conditions which may have a markedly elevated ESR include: • Rheumatoid arthritis, an autoimmune disease causing severe inflammation of the joints. ______ is protective treatment for the prevention of disease once exposure has occurred. Test ordering, the first step of the pre . Strategies to avoid these errors include th … Very serious errors in test results will occur is plasma from a _____top tube and a light-blue top tube is . The data entry into the hospital information system (HIS) may be incorrect, or the wrong patient may be selected. Errors occurring during the preanalytical phase - from the time the test is ordered by the physician until the sample is ready for analysis - can account for up to 93% of the errors currently encountered during the total diagnostic process, a review of multiple studies in 2002 showed similarly high levels of errors. Consequence: Unnecessary administration of antibiotic & extended length of hospitalization due to false-positive blood culture. The most frequent sources of pre-analytical errors are summarized in this slide. . Although other medical professionals (i.e. Promotion of ideal phlebotomy practices and sample transport procedures are a pre-requisite for the effective laboratory functioning. therapeutic. the practitioner manually perforated the vein. Tourniquets left on for more than 2 minutes or vigorous hand exercises can elevate potassium and lactic acid levels, and falsely decrease blood pH. Safety in the Lab and Phlebotomy environment: 2 • Demonstrate and practice techniques to safely . Ask the patient's nurse to turn off the IV for about two minutes prior to the venipuncture procedure. Preanalytical variables associated with phlebotomy include _____ specimens, transporting specimens, and proccessing specimens. Problems can also arise in the sampling process. b. Stroke/hemorrhage due to modification of blood thinner dosage based on inaccurate coagulation results. Venipuncture—"veni," meaning vein, and "puncture," meaning to pierce—is the act of drawing blood from a vein with a needle. SOURCES OF ERROR IN SPECIMEN COLLECTION, TRANSPORT PROCESSING AND STORAGE 5 1. Errors in data transmission include relaying or hearing verbal information incorrectly. Promotion of ideal phlebotomy practices and sample transport procedures are a pre-requisite for the effective laboratory functioning. Learn key terms, names, and much more related to Phlebotomy 4 Analytical Errors, Complications, Special Venipuncture with the help of our flashcards quizzes with ease. For this reason phlebotomy has been considered a separate area of specialization in developed countries. The dependence on accurate laboratory results for diagnostics makes it mandatory for labs to ensure accountability and accuracy of results to negate incorrect diagnosis as a consequence of faulty reporting. Error: Failure to properly cleanse site for blood culture collection; repalpating a site cleansed for blood culture collection; failure to allow antiseptic time to take effect prior to blood culture collection. The role of the phlebotomist and other healthcare providers who collect blood is crucial and begins the process of collection, testing, analysis, results/diagnosis and treatment. These include collection of samples, transportation, storage, and methodology used as well as intercurrent issues of the patients. In order to minimize the possibility of errors, phlebotomy procedures should be standardised, well-documented and written instructions should be available at every workstation. Errors in any aspect of blood sampling may require repeat samples, placing the patient at risk for blood loss and venous injury. Venipuncture requires good skills in order to perform the procedure not only . Results: During the observation period, 200 blood samples were drawn into 457 tubes by 5 phlebotomists and none of the . It is so important to the laboratory and to the patient and their satisfaction and quality of care. However this is one of the most frequent sources of error. . Test. Key Concepts: Terms in this set (23) Which of the following is a condition that causes an elevated hematocrit? Most common complication of phlebotomy procedure. Test requests can also be misinterpreted, unintelligible or get lost (Figures 4-5 4-5)) (6, 7, 33, 34). Explain the potential risks and complications of the venipuncture procedure. Hematology instruments are described . Hemoconcentration The increase in proportion . Unfortunately, there is a limited number of studies into the quality of blood sampling by venipuncture and the level of phlebotomists' knowledge of the . • Multiple myeloma or Waldenstrom's macroglobulinemia (tumors that make large amounts of immunoglobulins) typically have very high ESRs even if they don't have inflammation. 1,2. Identify patient 2.) Emphasis is placed on the knowledge and skills needed to collect all types of blood samples from patients. nurses . prophylaxis. assure free motion. Inversion 5. Inpatient: 1.0%. . Errors in test selection and ordering, patient identification and specimen labelling are pan-disciplinary and will not be discussed in this manuscript with particular reference to haematology. The adverse events that have been best documented are in blood transfusion services, where poor venepuncture practice or anatomical abnormality has resulted in haematoma . The activities involving phlebotomy, a critical task for obtaining diagnostic blood samples, are poorly studied as regards the major sources of errors and the procedures related to laboratory . In many patients, venous access is necessary for obtaining blood for laboratory testing and administering fluid and intravenous drugs. Laboratory errors constitute 1 of 7 quality events. Secondly, what is one of the reasons for a failed venipuncture? Venipuncture is also called phlebotomy, is a procedure in which a needle is used to take blood from a vein. This procedure is without complications, which sometime can be fatal. Sampling Errors. Polycythemia vera True or False? Additional errors within the ordering process may occur during the test requesting procedure itself. ScOoByBeArMaX. Upon successful completion of this course you will earn 2 continuing education . The activities involving phlebotomy, a critical task for obtaining diagnostic blood samples, are poorly studied as regards the major sources of errors and the procedures related to laboratory . Proper Procedure for Drawing Beneath an IV. Palpate veins in antecubital area (Figure 8) 4.) These negative outcomes can range from unnecessary redraws and delayed results, to improper treatment, misdiagnosis, and even death. source of skilled phlebotomists with or without cer-tification, Ernst says. These negative outcomes can range from unnecessary redraws and delayed results, to improper treatment, misdiagnosis, and even death. Venipuncture Procedure ----- ----- T3and T4Handling ----- . Outline the process of application for State certification. Repeated specimen rejection and the need to recollect blood samples create concerns about a laboratory's quality services and may . The curriculum at Oakton is in compliance with standardized educational curricula and accepted routes for national . Because these errors often are unknown, the analyst may inadvertently report erroneous patient results which could be harmful to the safety and well-being of the patient. Dependence on accurate laboratory results for establishing diagnosis makes it mandatory for labs to 2. Pre-analytical errors (Contd…) Patient Preparation: - Prior to collecting specimens for chemistry, certain patient variables need to be considered.