The venous sampling the main preanalytical errors that affect the validity of laboratory results
Article Sidebar
Main Article Content
Abstract
INTRODUCTION. Venous blood collection is an invasive procedure that is essential for in vitro diagnostics, as it represents an indispensable step to obtain the biological matrix to be analyzed. Although the analytical phase is not exempt from them, the majority of errors in laboratory medicine are concentrated in previous activities (pre-analytical phase) or follow (post-analytical phase) instrumental analysis of the samples. In particular, a percentage ranging from 60 to 70% of errors is concentrated in the preanalytic phase, especially in activities in which the human component is still decisive, such as venous blood collection.
TARGET. The aim of this work is to illustrate the main pre-analytical problems that may arise from errors related to the execution of the venous levy.
METHOD. Compatibly with the inevitable subjectivity inherent in the activity and the variables related to the environment and patient, the collection of suitable samples for the examination presupposes the implementation of appropriate and, as far as possible, standardized procedures.
RESULTS. Starting from the analysis of the standard procedures to perform a blood sample from venous puncture we will underline the main sources of pre-analytical errors.
CONCLUSION. Venous blood collection is an invasive procedure that is essential for in vitro diagnostics, as it represents a necessary step to obtain the biological matrix to be analyzed. It is important to prepare the recommendations for the execution of a blood sample, in order not to incur undesirable events both for the user and for the operator, and to define and standardize the knowledge and specific skills for the correct execution of the venous levy.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
RIMeL - IJLaM, Vol. 2, N. 3-S1, 2006 pag 70 (MAF Servizi srl ed.)
Plebani M. Towards quality specification in extra analytical phases of laboratory activity. Clin Chem Lab Med 2004;42:576-7.
Ricós C, Garcia-Victoria M, de la Fuente M. Quality indicators and specifications for the extra-analytical phases in clinical laboratory management. Clin Chem Lab Med 2004;42(6):578-82.
Plebani M, Ceriotti F, Messeri G, Ottomano C, Pansini N, Bonini P. Laboratory network of exellence: enhancing patient safety an service effectiveness. Clin Chem Lab Med 2006;44(2):150-60
Howanitz PJ. Errors in laboratory medicine: pratical lessons to improve patient safety. Arch Pathol Lab Med 2005;129: 1252-61.
Hollensead SC, Lockwood WB, Elin RJ. Errors in pathology and laboratory medicine: consequences and prevention. J Surg Oncol 2004;88:161-81.
Jones BA, Meier F, Howanitz PJ. Complete Blood Count Specimen Acceptability. Arch Pathol Lab Med 1995;119:203-8.
Bonini P, Plebani M, Ceriotti F, Rubboli F. Errors in laboratory medicine. Clin Chem 2002;48:691-8.
Jones BA, Meier F, Howanitz PJ. Complete Blood Count Specimen Acceptability. Arch Pathol Lab Med 1995; 119:203-8
Lippi G, Caputo M, Banfi G, et al. Raccomandazioni per il prelievo di sangue venoso. Biochim Clin 2008;32:569-77
Programma nazionale per le linee guida. Come produrre, diffondere e aggiornare raccomandazioni per la pratica clinica. Manuale metodologico. Istituto Superiore di Sanità, Maggio 2002.
Teresa Bizzoca. Prelievo venoso: ansia dolore correlato. Quotidiano sanitario nazionale Nurse 24 Available at:
https://www.nurse24.it/studenti/procedure/prelievo-venoso-ansia-dolore-correlato.html Pubblicato on-line il 10.04.18
Lippi G, Blanckaert N, Bonini P, et al. Causes, consequences, detection, and prevention of identification errors in laboratory diagnostics. Clin Chem Lab Med 2009;47:143-53.
Joint Commission. Laboratory services: 2013 National patient safety goals. Available at:
http://www.jointcommission.org/assets/1/6/2013_LAB_NPSG_final_10-23.pdf.
Gorski L, Hadaway L, Hagle M, McGoldrick M, Orr M, Doellman D. Infusion Therapy Standards of Practice. Journal of Infusion Nursing. 2016;39(1S):159.
Muzio Stornelli. Prelievo ematico difficile: linee guida. Quotidiano sanitario nazionale Nurse 24. Available at:
https://www.nurse24.it/studenti/procedure/prelievo-ematico-difficile-linee-guida.html Pubblicato on-line il 20.11.17
Lippi G, Sonntag O, Plebani M. Appropriate labelling of blood collection tubes: a step ahead towards patient's safety. Clin Chem Lab Med 2011;49:1921-3.
Plebani M, Caputo M, Giavarina D, et al. Note metodologiche sull’acquisizione e sull’uso dei sistemi chiusi sottovuoto per il prelievo, il trattamento e la conservazione dei campioni ematici venosi destinati alla diagnostica di laboratorio. Biochim Clin 2013;37:303-11
Lippi G, Salvagno GL, Montagnana M, et al. Venous stasis and routine hematologic testing. Clin Lab Haematol 2006;28:332-7.
Lippi G, Salvagno GL, Montagnana M, et al. Influence of short-term venous stasis on clinical chemistry testing. Clin Chem Lab Med 2005;43:869-75..
Lippi G, Salvagno GL, Montagnana M, et al.Short-term venous stasis influences routine coagulation testing. Blood Coagul Fibrinolysis 2005;16:453-8.
Lima-Oliveira G, Lippi G, Salvagno GL, et al. New ways to deal with known preanalytical issues: use of transilluminator instead of tourniquet for easing vein access and eliminating stasis on clinical biochemistry. Biochem Med 2011;21:152-9.
Lippi G, Salvagno GL, Montagnana M, et al. Phlebotomy issues and quality improvement in results of laboratory testing. Clin Lab 2006;52:217-30.
Lippi G, Salvagno GL, Montagnana M, et al. Quality standards for sample collection in coagulation testing. Semin Thromb Hemost 2012;38:565-75.
Lippi G, Avanzini P, Cosmai M, et al. Incomplete filling of lithium heparin tubes affects the activity of creatine kinase and gamma-glutamyltransferase. Br J Biomed Sci 2012;69:67-70.
Lippi G, Plebani M. Primary blood tubes mixing: time for updated recommendations. Clin Chem Lab Med 2012;50:599-600.2
Daves M, Lippi G, Cosio G, et al. An unusual case of a primary blood collection tube with floating separator gel. J Clin Lab Anal 2012;26:246-7.
Lippi G, Chance JJ, Church S, et al. Preanalytical quality improvement: from dream to reality. Clin Chem Lab Med 2011;49:1113-26.
Grant MS. The effect of blood drawing techniques and equipment on the hemolysis of ED laboratory blood samples. J Emerg Nurs 2003;29:116-21.