role of nurse in collection of blood sample

The nurses reflected on the fact that the sampling process was time consuming and planning their work could be a challenge. NA conducted the first interview. 2013 Mar;27(1):37-42. doi: 10.1016/j.bpa.2013.02.003. In regard to capillary sampling, one participant explained it as a minor procedure, while another stated it was seldom used. take the blood correctly so it can . Nurses in other clinical contexts have also described conflicting emotions when they deviate from instructions, have to hold patients still or when parents interfere during their childrens blood sampling [31]. Urine Specimen and Culture 4.1. Elo S, Kriinen M, Kanste O, Plkki T, Utriainen K, Kyngs H. Qualitative Content Analysis SAGE Open. Nurses' thoughts and needs regarding skills development in paediatric blood sampling Record the date and time of blood sample Unable to load your collection due to an error, Unable to load your delegates due to an error. J Child Health Care. [Risk of hemolysis in blood sampling from peripheral intravenous catheter: a literature review]. YELLOW The Swedish Handbook of Health Care [18] is mostly focused on adult care, as are the European Federation of Clinical Chemistry and Laboratory Medicine(EFLM) venous guidelines [19] and the American Clinical and Laboratory Standards Institute(CLSI) guidelines [20, 21]. They felt strengthened by colleagues in their team and shared feelings of responsibility to help each other with this complex procedure. 2020;34(3):1959. Srekovi NZ, Nedi ZP, Monti DM, D'Elia L, Dimitrijevi SB, Mihailovi NR, Katani Stankovi JS, Mihailovi VB. But they (the parents) are really important in it going well. Clin Chem Lab Med. NSP 048 V03 with alcohol. Nurses in other contexts have been found to lack knowledge about pre-analytical errors but are eager to learn [36], which was also the case with the nurses in our study. Park JM, Kim MJ, Yim HW, Lee WC, Jeong H, Kim NJ. National Library of Medicine J Emerg Nurs. The first author is a specialist paediatric nurse with preunderstanding of the blood sampling process and the affected errors. plasma samples. Another aspect was that some nurses lacked education concerning preparations and choosing the right blood sampling method, as well as knowledge about the amount of blood that could be taken from the children. The data used and analysed during the current study are available from the corresponding author on reasonable request. There was a difference between inexperienced and experienced nurses in the way they discussed sampling method. 3Diagnostic and Therapeutic Services Professional Nursing Lead, NHS Blood and Transplant. 2019;6(9):7201. As a phlebotomist, you will take blood samples from patients which are examined in a laboratory and the results can be used to quickly diagnose diseases and conditions. The nurses came from different wards in the hospitals, as well as from their emergency department. Provider Perspectives on Partnering With Parents of Hospitalized Children to Improve Safety. drawn and how patient tolerated the with lavender or green tops contain All phlebotomy attempts must be recorded. The informants were often experienced in adult care, where they felt self-confident, but this changed when they started working in the paediatric hospital. Remove the torniquet as soon as blood The participants thought they had the correct amount and were then perplexed when the laboratory responded by reporting the result to be an unfilled sample. with a Phycisians order. 2017;35(3):28095. An official website of the United States government. Clin Biochem. Although they might have thought a sampling went well, the hospital lab results recorded in the medical journal reported otherwise, due to pre-analytical errors, such as a clot or haemolysis. GREEN Frequency and causes of laboratory overuse in a hospital setting. to the culture bottles, Clean the culture bottle led with Moreover, children state that needle procedures are the worst experience of their hospital stay. Bisogni S, Aringhieri C, McGreevy K, Olivini N, Lopez JR, Ciofi D, et al. Gyllencreutz L, Pedersen I, Enarsson E, Saveman B-I, Blenius K. The experience of healthcare staff of incident reporting with respect to venous blood specimen collection practices. Part of kill the particular microorganism, When the patient has chills or a Venipuncture involves puncture a with a needle and https://doi.org/10.1515/dx-2018-0018. Often they defended this by expressing concerns for the children in that they did not want them to have too many punctures or suffer from hospital-acquired anaemia. moving sideways, Label the culture bottles and send Preisz A, Preisz P. Restraint in paediatrics: A delicate balance. Guaiac Fecal Occult Blood Test (gFOBT) 4. The authors would like to express our appreciation to the nurses who agreed to share their experiences with us and made this study possible. collection, the name of the test, the amount Feeling stressed and wanting to perform high quality care but being unsuccessful was another challenging aspect. FOIA Finger pricks, such as for blood sugar tests or to determine blood type. The nurses felt that they first had to build the childrens confidence to ensure the blood sampling procedure went smoothly. PINK. Handbook of Health Care, Stockholm, Sweden, 2018, Available from: http://www.vardhandboken.se/Texter/Blodprov-kapillar-provtagning/Tillvagagangssatt/. A comparison of hemolysis rates using intravenous catheters versus venipuncture tubes for obtaining blood samples. USP units anticoagulant for Available from: https://www.ncbi.nlm.nih.gov/books/NBK138647/. Geneva: World Health Organization; 2010. The authors (HH, NA, BMY) familiarized themselves with the data and then discussed the initial patterns after the coding. Blood collection tubes - Colour coding of vials, Order of draw, Sample collection and safety procedure in laboratory, Clinical Resource Nurse at King Fahad Central Hospital, Methods of Blood Collection and Anticoagulants, Blood collection, precautions to prevent hemolysis and, sample collection in clinical biochemistry, Blood transfusion by M.Sc.Second year, 2020-21 Btach, SVBCON, Silvassa, Laboratory diagnosis of_infectious_diseases. 2020 Jan 9;29(1):60-61. doi: 10.12968/bjon.2020.29.1.60. 1cm for the tube stopper. The nurses also expressed awareness that children of certain ages or with special needs could present an extra challenge to the procedure. Overall, venous sampling was more often considered the first and best choice because blood flow would be better and more blood could be collected. A 6ml draw tube with K2 EDTA The https:// ensures that you are connecting to the This finding was significant (x2 < 0.001). Federal government websites often end in .gov or .mil. Grahn M, Olsson E, Mansson ME. The chiasm: transfusion practice versus patient blood management. https://doi.org/10.1177/0898010116660397. Our purposive sampling approach had this intention. lancet or any broken glass are put in a special 8600 Rockville Pike There is a lack of evidence surrounding paediatric nurses experiences of the blood sampling procedure with children and of their experiences of the errors occurring in the pre-analytical phase. Prof Inferm. In general, the existing national and international guidelines for blood sampling procedures specific to paediatric hospital care are thinly designed. The overall main theme Paediatric blood sampling is a challenge for the nurses illustrates that nurses working in paediatric hospital care face a big challenge with the blood sampling collection procedure for children. skin for at least 1 minute, Insert the needle into the vein and Collaborate with teams to plan for patient care. Im not asking help for my sake I can push the needle in ten times but its for the childs sake, isnt it so you dont damage the vessels. (Nurses Group 1). Nurses need to be aware of how to properly gather specimens, both for self-protection, and to prevent the spread of diseases. The role of nurses in blood services and donor sessions C N l T NT CliNiCal is an essentialN resource for extending your knowledge base. Before Unauthorized use of these marks is strictly prohibited. Before Monitor patient health and record signs. Accessibility When sharp box reaches full close, tape, date What Is a Phlebotomist? What They Do & Training - Cleveland Clinic and techniques are used in collection, storage, transport of blood sample, Preparation of the Patient and Environment. These findings could be transferable to other similar contexts where paediatric nurses are in charge of the procedure, although we believe nurse assistants, phlebotomists or even doctors performing blood sampling on children could have similar experiences and gain knowledge by reading this paper. The United Nations childrens convention from 1989 confirmed the rights of children to be supported, protected and respected, and for them to participate with their dignity recognised. Transfus Med Rev. Of these, 28 intravenous catheter samples (5.6%) were found to be hemolyzed, whereas only 1 venipuncture sample (0.3%) was hemolyzed. Advocate for the health and wellbeing of patients. Lippi G, Banfi G, Church S, Cornes M, De Carli G, Grankvist K, et al. Specimen collection Nelson Munthali 99.6K views27 slides. Further research needs to focus on improving the support and education of nurses performing blood sampling on children and in so doing, reducing the pre-analytical errors in paediatric hospital care. Morgan DL. If not the machines, could it be the quality of materials or even sloppy laboratory staff? What counts as quality practice in (reflexive) thematic analysis? Prepared by: Gianne T. Gregorio RN. Molecules. OBJECTIVES: To review Policy and Procedure in obtaining blood samples in KFCH. Horn K, Pilkington L, Hooten P. Pediatric Staff Nurses Conceptualizations of Professional Development. modality, type of specimen drawn, time Cookies policy. We included two hospitals to be able to cover a wider range views and experiences. Possible consequences of pre-analytical errors are many: delayed treatment, wrong diagnosis, repeated sampling and increased costs [5,6,7]. Methods. 2018 Apr;28(2):150-157. doi: 10.1111/tme.12476. 2019. p. 110. Reconsidering the role of interaction in analyzing and reporting focus groups. bottles, Label and number the container in The participants had many thoughts and ideas on educational aspects, such as being given a good introduction to paediatric blood sampling, practical tips and repeated training in order for them to feel comfortable with the procedure. https://doi.org/10.1515/cclm-2018-0602. If the specimen is inadequate should be used for collection of blood, The top of the bottle must be It was necessary to plan your procedure accordingly, due to the few available chances nurses have for collecting blood. They must be filled to the level You have entered an incorrect email address! Nevertheless, they felt strengthened by colleagues in their team and shared feelings of responsibility to help each other with this complex procedure. This includes improved communication and provision of support and education to nurses and doctors, as well as the patients. Unauthorized use of these marks is strictly prohibited. To avoid needle prick injuries. Braun V, Clarke V. Using thematic analysis in psychology. outward from the site. To detect the microorganisms ; To treat the disease condition with correct antibiotics ; To detect the right antibiotic to kill the particular microorganism The authors declares that we does not have any competing interests. 2018;54:8591. The organisation of data went through the six described phases, including transcribing, making notes and coding, and creating themes composed from code patterns and meaning of data [28]. 2007;19(6):34957. Evaluating venepuncture practice on a general childrens ward. NurseReview.Org Common Laboratory Procedures, sample collection in clinical biochemistry, Common laboratory & diagnostic procedures, 3rdPre-analytical-Laboratory-Errors-Dr-sami 2.ppt, 3rdPre-analytical-Laboratory-Errors-Dr-sami.ppt, Sample collection and safety procedure in laboratory, NurseReview.Org - Study Skills and Test Strategies for the New Nursing Student, NurseReview.Org - Introduction to Mechanical Ventilation, Test Taking Strategies For Nursing Students. Literature has described an overutilization of laboratory testing in hospital settings and that resting is often of no clinical importance [42]. 2014 Nov 18;29(11):35-9. doi: 10.7748/ns.29.11.35.e8934. collection The nurses ambiguity and uncertainty seemed to nudge them into a blaming culture. Yes, theres a huge difference when youre working on adults but with a child it could be a process that takes a whole morning just to get near them. (Nurses Group 2). They were also worried that all this sampling could lead to risk of hospital-acquired anaemia. 2.3 Select correct equipment and blood collection tubes and place in order of draw to ensure the collection accords with test requested. The nurses could have been helped further if the guidelines had been more specific about when to use which sampling method for age and developmental stages and analyses. Blood samples were processed and assessed for hemolysis using standard procedures by laboratory technicians who were blinded to the collection method. This dilemma illuminates the knowledge gap and the grey zone between nursing care and laboratory medicine in paediatric hospital care. anticoagulant for Blood specimen collection - SlideShare Everyone should get trainedjust like getting CPR once a year, you can have needle training once a year. (Nurses Group 1). This made the nurses feel insecure and could lead to lack of confidence and trust between the nurse and child. temperature hike, Special type of culture bottles are 8600 Rockville Pike (Nurses Group 3). Federal government websites often end in .gov or .mil. Malterud K, Siersma VD, Guassora AD. This highlights the wide range of issues a paediatric nurse must cope with when executing blood sampling. Improving anti-cancer drug delivery performance of magnetic mesoporous silica nanocarriers for more efficient colorectal cancer therapy. Arslan FD, Karakoyun I, Basok BI, Aksit MZ, Celik E, Dogan K, et al. OSHA requires sharp collection container to be Shander A, Corwin HL. following the policy for blood specimen HHS Vulnerability Disclosure, Help CLSI. PubMed 1Regional Lead Nurse, Nursing Care Quality Team, NHS Blood and Transplant. Due to there being only fragmented previous knowledge of our research question [23, 24], we converged the TA with an inductive approach, as described by Clark & Braun (2006) and recently clarified and discussed by the same (2020). Please enable it to take advantage of the complete set of features! Policy and Procedure in obtaining blood or evidence of hematoma. Qual Health Res. OUTLINE Definition of Blood Specimen Collection . Physical assessment Nelson Munthali . The role of nurses in blood services and donor sessions. Our Mission Is To Make a Digital E-book Platform For Nursing Students And Nurses. (Nurses Group 1). A staff nurse may perform the procedure touching the skin before it has been disinfected, Cleanse the skin over the AOP 007-v01 Nurses experiences of blood sample collection from children: a qualitative study from Swedish paediatric hospital care. In other needle-related procedures, such as venous access in children, nurses have reported increased job satisfaction, performance as well as improved relationship with patient and family when they learned more about pain management for the procedure [34]. Even though we used a more inductive approach, it is meaningful to say that as researchers, we are not in a theoretical vacuum with no previous knowledge. Papa A, Zempsky W. Nurse Perceptions of the Impact of Pediatric Peripheral Venous Access Pain on Nurse and Patient Satisfaction. Nurses' Experiences of Blood Sample Collection from Children: A The cost of poor blood specimen quality and errors in preanalytical processes. The thinking around sampling and perhaps a bit more on which ones I can actually take from capillaries and which ones have to be venous, so thats what I wish I had in my training. (Nurses Group 3). Unable to load your collection due to an error, Unable to load your delegates due to an error. BLOOD SPECIMEN COLLECTION AND STANDARD OPERATING PROCEDURE FOR DISPOSAL OF SHARP OBJECTS Prepared by: Gianne T. Gregorio RN. Parents can often unwittingly transfer their own fears and anxiety to their children, something nurses must often be well-prepared to manage. A flexible interview guide was first conducted by the main author (HH) and then discussed and revised by the co-authors (NA, BMY). Ethical approval and consent to participate is presented in the manuscript. Actual implementation of sick childrens rights in Italian pediatric units: a descriptive study based on nurses perceptions. Karcher DS, Lehman CM. MeSH Bethesda, MD 20894, Web Policies Disclaimer. gentle pressure to the punctured site until Epub 2010 Oct 2. Nurses on childrens wards play an active role in helping the children with the experience and also in reducing potential adverse effects of blood sampling collection [1]. Clin Chem. While this article focuses on anaemia-related transfusions, the author relates the principles of patient blood management to all transfusion care. Blood donation: nurse roles and responsibilities - PubMed 2007;53(7):133842. withdraw blood, After the needle has been removed, Simply allow the tube to Unfortunately, the blood sampling collection procedure is often affected by pre-analytical . Nurses experiences of blood sample collection from children: a qualitative study from Swedish paediatric hospital care, https://doi.org/10.1186/s12912-022-00840-2, https://www.swenurse.se/download/18.9f73344170c00306231740/1584023319857/kompetensbeskrivning%20legitimerad%20barnsjuksk%C3%B6terska.pdf, http://www.vardhandboken.se/Texter/Blodprov-kapillar-provtagning/Tillvagagangssatt/, https://www.ncbi.nlm.nih.gov/books/NBK138647/, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/. Another study has also pointed out that the organization must recognise that extra time and a high level of clinical competence and resources are needed for advanced paediatric care [16]. COREQ contains a 32-item checklist including three domains: 1) research team and reflexivity, 2) study design and theoretical framework and, 3) analysis and findings [26]. from a Physician. (Nurses Group 1). Limitations: of blood for blood culture is a sterile procedure. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Consequently, as a nurse you could execute a perfect distracted and comfort measured blood sampling procedure but still fail to get a satisfactory blood test result from the laboratory. Current Status of Phlebotomy Training Among Novice Nurses in Japan: A (Nurses Group 3). The site is secure. Additionally, the participants felt that moments such as preparations could be challenging but were very important. eCollection 2022. Administer medications and treatments. Therefore, the aim of this study therefore was to describe paediatric nurses experiences of blood sampling collections from children. The nurses believed it was more of a challenging process to take blood samples from children than from adults. The nurses often had to deal with the anxiety and fears of both the child and their parents. Blood sampling is a multifaceted task and the nurses described their skills in planning for the best interests of the child. 2006;3(2):77101. to the procedure. From the study data, we described one major theme and four subthemes, which relates to successful or unsuccessful blood sampling procedures. When the nurses could not believe it was their own mistake, they tried to give other explanations for why sampling was unsuccessful. 2018;37(2):17280. Surgical (scrub) preparation and techniques are used in collection, storage, transport of blood sample . serum samples. Clin Chem Lab Med. Adv Emerg Nurs J. 2014;9:23063. The effect of blood drawing techniques and equipment on the hemolysis of ED laboratory blood samples. Capillary blood sampling was seen as an option when the child had few visible veins or had special needs. and transmitted securely. They played the role of a patient and a nurse and were administered a survey at the end of the training. 2018;8(6):3307. 007-V01 Best Pract Res Clin Anaesthesiol. A low-cost, open-source centrifuge adaptor for separating large volume clinical blood samples. Blue and gray tops also contain liquid carefully disinfected (with 70% alcohol) just before the bottle is inoculated, Blood should never be taken from an Heel pricks, which are specifically for infants. Interestingly, the safety of both personnel and child were seldom discussed, even though the different sampling methods incur different risks for both patient and staff and are described in WHO phlebotomy guidelines [22]. To assure the safety of the child and protect its rights, nurses must use their clinical judgement in each situation and for each individual child so that they can appropriately tailor the best preparations and interventions, before, during and after the procedure [32]. In our study, having an assistant on hand to stabilize the arm or distract the patient was viewed as important, which is consistent with the recommendations in CLSI venepuncture guidelines [20]. Recommendations PMC Children in hospital are a vulnerable group and any restraining should be minimized by good planning and adjusted pain relief methods by the healthcare personnel with focus on the patients dignity and privacy [30]. During the interviews, the nurses described experiences which showed that they had a deeper understanding of the childs needs and comfort. They could not believe it when the blood sample came back from the laboratory as a failed analysis, which created stress, anger and frustration. This may be done by implementing the latest evidence-based research in this field, along with a childrens rights approach. pulling the plunger of the syringe gently. Discussion: Henrik Hjelmgren. Thats always the ethical question thats difficult. record sheet. BLUE Clinical Consequences of Specimen Rejection A College of American Pathologists Q-Probes Analysis of 78 Clinical Laboratories. regarding waste disposal not only for sharps 2008 Jun;34(3):196; author reply 196-7. doi: 10.1016/j.jen.2008.03.005. https://doi.org/10.1186/s12912-022-00840-2, DOI: https://doi.org/10.1186/s12912-022-00840-2. Importance of Specimen Collection Nurses' Roles in Specimen Collection 1. This study used focus groups, which is a method that could give the researcher a certain depth of data and context. Collection of blood for blood culture is a sterile procedure. Willock J, Richardson J, Brazier A, Powell C, Mitchell E. Peripheral venepuncture in infants and children. Rosenberg RE, Williams E, Ramchandani N, Rosenfeld P, Silber B, Schlucter J, et al.
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