A current status survey and analysis of venous blood collection by nurses and countermeasures

Abstract

Objective To provide some references for improving the quality of blood specimen collection through a survey of the knowledge of the clinical nursing staff for the Clinic of Internal Medicine about venous blood collection and retrospective analysis of the occurrence of unqualified blood specimens. Methods Convenience sampling was adopted. In March, 2018, the surveyors surveyed 371 in-service clinical nursing staff members of the Clinic of Internal Medicine using the general information questionnaire and the questionnaire on the clinical status of venous blood collection. The surveyors retrospectively analyzed the occurrence of unqualified specimens at the inpatient and outpatient wards of the Clinic of Internal Medicine from October, 2017 to March, 2018 as reported by the Laboratory Medicine of the Hospital. Results A total of 378 questionnaires were distributed, and 371 valid questionnaires were recovered, with an effective recovery rate of 98.14%. Specifically, the nurses' awareness rates of the order of multi-tube collection (15.36%), the timing of tube withdrawal/replacement (43.94%), the method of mixing blood specimen (14.56%), the timing of loosening tourniquet (21.83%), and the method of handling blood collection difficulty (8.63%) were low. There were 781 unqualified blood specimens at the inpatient and outpatient wards of the Clinic of Internal Medicine, while the total sample size was 410 493. The unqualified specimen rate was 0.190%. The main causes of the unqualified specimens were hemolysis (26.50%), coagulation (20.61%), insufficient specimen quantity (11.27%), and container error (10.24%). Conclusion The nurses have inaccurate and non-comprehensive knowledge of venous blood collection, and the incidence of unqualified specimens is high. The training and assessment of the nursing staff's blood collection knowledge should be strengthened; the operating procedure standardized; a blood specimen quality control system established; and the collection quality of blood specimens improved. Key words: Venous blood collection; Blood specimen; Current status survey; Countermeasures