Reduction of the Burden of Repeated Blood Samples in NICU
Keywords:Repeated blood investigation, insufficient samples, clotted samples, haemolyzed samples, Burden of repeating investigations, simple measure to prevent repeat blood investigation
In our unit, there are about 1700 blood tests in the year that need repeating, due to clotting, haemolysis or insufficiency. In addition to wasting staff time, this is unpleasant for babies and parents.
We initially recorded how many samples needed repeating in two weeks to get an idea about yearly numbers. We emailed all staff, involved in sampling, explaining the project and how they could help.
Posters illustrating key points were placed on each blood sampling trolley and updated with each cycle. The project was discussed in safety brief meeting each morning.
Number of repeated samples was assessed on weekly basis after implementing the changes. Several PDSA cycles were performed.
Repeated FBC samples reduced from 11% to 7%, and repeated biochemistry blood samples reduced from 15% to 10% overall. Results for repeated clotting samples were unstable over time.
Education regarding simple measures as warming the foot, not squeezing, allowing venous return, allow the blood to flow into the bottle without scraping and mixing the FBC sample but not biochemistry sample helped in achieving our target. Small numbers may have influenced the results for clotting.
Open discussion with the team, highlighting areas that require improvement, in addition to empowering the nurses to consider early a venous sample if they are struggling with heel pricks was fruitful.
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Copyright (c) 2022 Alaa Hassan, Katie Hunt
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