10603
Pediatric Blood Sparing: An Interdisciplinary Improvement Initiative to Reduce Pre-analytical Blood Collection Errors
The goal of the nursing staff-laboratory task force was to improve the quality and safety of blood collection practices by creating a reference tool and staff education module focused on standardizing/minimizing blood draw volumes and preventing test result errors.
Significance:
Pre-analytical collection errors require test cancellations/re-draws that delay patient diagnosis, treatment and throughput, and cause patient distress. Inefficient practices impact institutional quality, financial performance, patient satisfaction scores, and recruitment of future clients.
Strategy and Implementation:
For data to be used effectively in making health care improvement decisions, it must be accessible, communicated across departments and reported in a format that is easily translated into action plans. Collaborative efforts utilized 7 months of laboratory test data to identify the 50 most frequently ordered pediatric blood tests and reasons for test cancellations. A standardized reference tool was developed that identified the absolute minimum, preferred and add-on blood volumes required for test performance, appropriate collection tube selection and special handling requirements for each test. Guidelines were color coded by test tube and piloted on 2 divisions following staff education. Pilot results reflected a reduction in the numbers of cancelled tests without an increase in turnaround time for test analysis and result reporting. The guidelines were expanded, published and implemented on all pediatric divisions, following staff education.
Evaluation:
An interdisciplinary team approach was vital in creating buy-in across departments. Outcomes were measured by the numbers of specimens collected in incorrect tubes; numbers of tests cancelled due to improperly collected specimens; and compliance with turnaround time for reporting test results.
Implications for Practice:
Only 30% of change projects achieve intended outcomes. Successful changes require knowledge of and buy in to the purpose. Meaningful data, utilized as an information base and a learning tool for staff education, strategically leverages change that produces real and sustainable improvements.