DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20203923

Comparison of knowledge, attitude and practices in routine blood and urine collection among final year laboratory technician students, nursing students and house surgeons

Johns John, Kavitarati Dharwadkar, Jini Muttam Paul

Abstract


Background: Laboratory services are the backbone of the modern health care sector. In spite of rapid advances in laboratory science, it is still susceptible to various manual and systemic errors. Pre-analytical phase includes specimen collection, storage, separation and transport. Errors in this phase are majorly due to human mistakes and the majority of these errors are preventable. Laboratory technicians and nursing staff from in-patient care are most commonly and directly involved in sample collection. There are many studies done using them as study population. However, the role of physician in sample collection techniques is often ignored. Ideally a doctor should also be aware of the sample collection techniques and anticipate possible lab errors due to pre-analytical error.

Methods: A quantitative cross sectional comparative study with 60 participants comprising 20 each from house surgeons, final year lab technicians and nursing students in a tertiary care hospital. A pre-tested, self-administered and validated questionnaire was used to assess knowledge, attitude and practices in routine blood and urine collection with total 27 questions. Statistical analysis: ANOVA, student’s t- test and qualitative analysis was done.

Results: In the area of sample collection techniques house surgeons lacked the required knowledge compared to nursing and lab technician students and it was also reflected in sample collection practices.

Conclusions: Based on the study, we strongly opine to train MBBS students in routine blood collection techniques and sensitize them to pre analytical errors which will help in reducing lab reporting errors.

1.        Narayanan S. The preanalytic phase. An important component of laboratory medicine. Am J Clin Pathol. 2000;113:429-52.

2.        Lombardi G, Sansoni V, Banfi G. Measuring myokines with cardiovascular functions: pre-analytical variables affecting the analytical output. Ann Transl Med. 2017;5(15):299.

3.        Favaloro EJ, Oliver S, Mohammed S, Ahuja M, Grzechnik E, Azimulla S, et al. Potential misdiagnosis of von Willebrand disease and haemophilia caused by ineffective mixing of thawed plasma. Haemophilia. 2017;23(5):e436-43.

4.        Kárai B, Miltényi Z, Gergely L, Száraz-Széles M, Kappelmayer J, Hevessy Z. The impact of delayed sample handling and type of anticoagulant on the interpretation of dysplastic signs detected by flow cytometry. Biochem Med (Zagreb). 2018;28(2):020704.

5.        Burtis CA, Burns DE. Tietz Fundamentals of clinical chemistry and molecular diagnostics. 6th edition. Part 1;3:42-43 Elsevier, Amsterdam; 2017:1075.

6.        Carraro P, Plebani M. Errors in a stat laboratory: types and frequencies 10 years later. Clin Chem. 2007;53:1338-42.

7.        Boone DJ. Governmental perspectives on evaluating laboratory performance. Clin Chem. 1993;39:1461-7.

8.        Astion ML, Shojania KG, Hamill TR, Kim S, Ng VL. Classifying laboratory incident reports to identify problems that jeopardize patient safety. Am J Clin Pathol. 2003;120(1):18-26.

9.        Rana SV. No preanalytical errors in laboratory testing: a beneficial aspect for patients. Indian J Clin Biochem. 2012;27(4):319-21.

10.    

Cite this article as: John J, Dharwadkar K, Paul JM. Comparison of knowledge, attitude and practices in routine blood and urine collection among final year laboratory technician students, nursing students and house surgeons. Int J Community Med Public Health 2020;7:3559-67.

Medical Council of India regulations on graduate medical education 1997 (amended on July 2017). The gazette of India dated May 17, 1997. Part 3(4):1701-1726. Available from: https://www.mciindia.org/documents/rulesAndRegulations/GME_REGULATIONS.pdf. Accessed on 18 January 2018.

11.     Lalongo C, Bernardini S. Preanalytical investigations of phlebotomy: methodological aspects, pitfalls and recommendations. Biochem Med. 2017;27(1):177-91.

12.     Wallin O, Söderberg J, Van Guelpen B, Stenlund H, Grankvist K, Brulin C. Blood sample collection and patient identification demand improvement: a questionnaire study of preanalytical practices in hospital wards and laboratories. Scand J Caring Sci. 2010;24(3):581-91.

13.     Sindhulina C, Joseph NJ. Addressing sample identification errors in a multispecialty tertiary care hospital in Bangalore. Vox Sang. 2014;07(2):153-7.

14.     Stankovic AK1, Di Lauri E. Quality improvements in the preanalytical phase: focus on urine specimen workflow. Clin Lab Med. 2008;28(2):339-50, viii.

15.     Cornes M, van Dongen-Lases E, Grankvist K, Ibarz M, Kristensen G, Lippi G, et al. Order of blood draw: opinion paper by the European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for the Preanalytical Phase (WG-PRE). Clin Chem Lab Med. 2017;55(1):27-31.

16.     Lima-Oliveira G, Lippi G, Salvagno GL, Montagnana M, Mangueira C, Sumita N, et al. New ways to deal with known preanalytical issues: use of trans illuminator instead of tourniquet for easing vein access and eliminating stasis on clinical biochemistry. Biochem Med. 2011;21:152-9.

17.     Asirvatham JR, Moses V, Bjornson L. Errors in potassium measurement: a laboratory perspective for the clinician. North Am J Med Sci. 2013;5(4):255-9.

18.     Cai Q, Zhou Y, Yang D. Nurses’ knowledge on phlebotomy in tertiary hospitals in China: a cross-sectional multicentric survey. Biochemia Medica. 2018;28(1):010703.

19.     Forsman RW. Why is the laboratory an afterthought for managed care organizations? Clin Chem. 1996;42:813-6.

20.     Syllabus and curriculum of Bsc Nursing: KUHS. Available at: http://www2.kuhs.ac.in/kuhs_new/ images/uploads/pdf/academic/courses-syllabus/ Nursing/bscnursing_04012018.pdf. Accessed on 5 September 2018.

21.     Diploma in Medical laboratory technology (DMLT). Syllabus. Available at: http://www2.kuhs.ac.in/ kuhs_new/images/uploads/pdf/academic/courses-syllabus/old_Syllabus_upto2016/Allied/4.B.ScMlt.pdf. Accessed on 05 September 2018.

Osegbe ID, Afolabi O, Onyenekwu CP. The effectiveness of clinician education on the adequate completion of laboratory test request forms at a tertiary hospital. Ann Med Health Sci Res. 2016;6(2):90-4.

Keywords


Blood, House surgeons, Lab technician students, Nursing students, Pre analytical errors

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References


Narayanan S. The preanalytic phase. An important component of laboratory medicine. Am J Clin Pathol. 2000;113:429-52.

Lombardi G, Sansoni V, Banfi G. Measuring myokines with cardiovascular functions: pre-analytical variables affecting the analytical output. Ann Transl Med. 2017;5(15):299.

Favaloro EJ, Oliver S, Mohammed S, Ahuja M, Grzechnik E, Azimulla S, et al. Potential misdiagnosis of von Willebrand disease and haemophilia caused by ineffective mixing of thawed plasma. Haemophilia. 2017;23(5):e436-43.

Kárai B, Miltényi Z, Gergely L, Száraz-Széles M, Kappelmayer J, Hevessy Z. The impact of delayed sample handling and type of anticoagulant on the interpretation of dysplastic signs detected by flow cytometry. Biochem Med (Zagreb). 2018;28(2):020704.

Burtis CA, Burns DE. Tietz Fundamentals of clinical chemistry and molecular diagnostics. 6th edition. Part 1;3:42-43 Elsevier, Amsterdam; 2017:1075.

Carraro P, Plebani M. Errors in a stat laboratory: types and frequencies 10 years later. Clin Chem. 2007;53:1338-42.

Boone DJ. Governmental perspectives on evaluating laboratory performance. Clin Chem. 1993;39:1461-7.

Astion ML, Shojania KG, Hamill TR, Kim S, Ng VL. Classifying laboratory incident reports to identify problems that jeopardize patient safety. Am J Clin Pathol. 2003;120(1):18-26.

Rana SV. No preanalytical errors in laboratory testing: a beneficial aspect for patients. Indian J Clin Biochem. 2012;27(4):319-21.

Medical Council of India regulations on graduate medical education 1997 (amended on July 2017). The gazette of India dated May 17, 1997. Part 3(4):1701-1726. Available from: https://www.mciindia.org/documents/rulesAndRegulations/GME_REGULATIONS.pdf. Accessed on 18 January 2018.

Lalongo C, Bernardini S. Preanalytical investigations of phlebotomy: methodological aspects, pitfalls and recommendations. Biochem Med. 2017;27(1):177-91.

Wallin O, Söderberg J, Van Guelpen B, Stenlund H, Grankvist K, Brulin C. Blood sample collection and patient identification demand improvement: a questionnaire study of preanalytical practices in hospital wards and laboratories. Scand J Caring Sci. 2010;24(3):581-91.

Sindhulina C, Joseph NJ. Addressing sample identification errors in a multispecialty tertiary care hospital in Bangalore. Vox Sang. 2014;07(2):153-7.

Stankovic AK1, Di Lauri E. Quality improvements in the preanalytical phase: focus on urine specimen workflow. Clin Lab Med. 2008;28(2):339-50, viii.

Cornes M, van Dongen-Lases E, Grankvist K, Ibarz M, Kristensen G, Lippi G, et al. Order of blood draw: opinion paper by the European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for the Preanalytical Phase (WG-PRE). Clin Chem Lab Med. 2017;55(1):27-31.

Lima-Oliveira G, Lippi G, Salvagno GL, Montagnana M, Mangueira C, Sumita N, et al. New ways to deal with known preanalytical issues: use of trans illuminator instead of tourniquet for easing vein access and eliminating stasis on clinical biochemistry. Biochem Med. 2011;21:152-9.

Asirvatham JR, Moses V, Bjornson L. Errors in potassium measurement: a laboratory perspective for the clinician. North Am J Med Sci. 2013;5(4):255-9.

Cai Q, Zhou Y, Yang D. Nurses’ knowledge on phlebotomy in tertiary hospitals in China: a cross-sectional multicentric survey. Biochemia Medica. 2018;28(1):010703.

Forsman RW. Why is the laboratory an afterthought for managed care organizations? Clin Chem. 1996;42:813-6.

Syllabus and curriculum of Bsc Nursing: KUHS. Available at: http://www2.kuhs.ac.in/kuhs_new/ images/uploads/pdf/academic/courses-syllabus/ Nursing/bscnursing_04012018.pdf. Accessed on 5 September 2018.

Diploma in Medical laboratory technology (DMLT). Syllabus. Available at: http://www2.kuhs.ac.in/ kuhs_new/images/uploads/pdf/academic/courses-syllabus/old_Syllabus_upto2016/Allied/4.B.ScMlt.pdf. Accessed on 05 September 2018.

Osegbe ID, Afolabi O, Onyenekwu CP. The effectiveness of clinician education on the adequate completion of laboratory test request forms at a tertiary hospital. Ann Med Health Sci Res. 2016;6(2):90-4.