Improving Phlebotomy Practices Through Small-Volume Blood Tubes: A Survey-Based Study

Abstract

Aim: The blood collection for laboratory tests has been frequently performed due to evidence-based medicine. We aimed to conduct a survey on phlebotomy among phlebotomists and patients and to reduce unnecessary blood loss by using small-volume blood collection tubes.
 Material and Method: A survey among phlebotomists and patients was conducted to gather their opinions. Phlebotomists received training on the importance of the preanalytical process. The blood volume required for laboratory tests was reduced by 33.3%-50.0% in children and adults, and 63.0%-84.0% in newborns. Following this intervention, we investigated its effects on the blood transfusion ratio in the neonatal and adult intensive care unit (NICU and ICU) and the amount of laboratory medical waste generated.
 Results: A majority of phlebotomists (91.8%) reported difficulties in drawing blood from newborns, pediatric, oncology, hematology, and geriatric patients. Additionally, 68.9% of phlebotomists and 57.1% of patients expressed an opinion for reduced blood volume. Despite an increase in the number of laboratory tests (28.4%) and samples (15.7%), we observed a 17.8% reduction in the amount of laboratory medical waste. Although the number of patients in NICU increased statistically significant, the increase in transfusion rates was not significant. Although the number of patients in ICU increased, transfusion rates decreased, but neither was found to be statistically significant.
 Conclusion: Post-graduation, phlebotomists should be educated regularly about the preanalytical process. Based on the opinions of both phlebotomists and patients, using small-volume tubes in patients with difficult blood collection may increase their satisfaction. Generally, laboratory medical waste may be reduced.