Intensive educational efforts combined with external quality assessment improve the preanalytical phase in general practitioner offices and nursing homes

• Published in: Clinical chemistry and laboratory medicine Vol. 55; no. 12; pp. 1857 - 1864
• Main Authors: Sølvik, Una Ørvim, Bjelkarøy, Wenche Iren, Berg, Kari van den, Saga, Anne Lise, Hager, Helle Borgstrøm, Sandberg, Sverre
• Format: Journal Article
• Language: English
• Published: Germany De Gruyter 26.10.2017; Walter De Gruyter & Company
• Subjects: Blood; Blood circulation; Blood Specimen Collection; capillary and venous blood sampling; Education; EQA; General Practitioners - education; Guidelines; Health care; Humans; labeling; Laboratories; Launching; Norway; Nurses; Nursing Homes; Offices; patient identification; Patient Safety; point-of-care (POC); Polls & surveys; preanalytical phase; Quality assessment; Quality Control; Quality Improvement; Routines; Sampling; Surveys and Questionnaires; capillary and venous blood sampling; point-of-care (POC); EQA; preanalytical phase; patient identification; labeling
• ISSN: 1434-6621; 1437-4331
• DOI: 10.1515/cclm-2016-1152

Errors in the preanalytical phase in clinical laboratories affect patient safety. The aim of this study was to evaluate the effect of intensive educational efforts together with external quality assessment (EQA) of the preanalytical phase from 2013 to 2015 to improve patient identification in primary health care in Norway. In addition, routines for venous and capillary blood sampling were investigated. A preanalytical EQA was circulated in 2013 by the Norwegian Quality Improvement of Laboratory Examinations (Noklus) to general practitioner offices and nursing homes (n=2000) to obtain information about important issues to focus on before launching an intensive educational program with courses, posters and visits in 2013-2015. Preanalytical EQA surveys were further circulated in 2014 and 2015. The response rate varied between 42% and 55%. The percentages of participants asking for the patients' name and the Norwegian identification number increased from about 8% in 2013 to about 35% in 2015. The increase was similar for those participating in only one EQA survey and for those who participated in EQA surveys both in 2013 and 2015. Guidelines for venous and capillary blood sampling were not always followed. Educational efforts more than the preanalytical EQA influenced the actions and resulted in an increase in the percentages of participants that followed the guidelines for patient identification. Some aspects of blood sampling routines need improvement.