Researchers in  Tunisia set out to determine the relative rate of compliance with industry standards among healthcare professionals who draw diagnostic blood samples. Their results, published last year in La Tunisie Medicale show the need for a nation-wide improvement plan, according to the authors.

The research team audited 330 phlebotomy procedures by observation at the 667-bed Hôpital Universitaire Sahloul Sousse, Tunisia in 2015. They referred to practice guidelines published by the World Health Organization and the European Federation for Laboratory Medicine's Preanalytical Working Group, which reflected CLSI's venipuncture standard GP41-A6. All scoring was conducted by two public health nurses practicing in the Prevention and Health Care Department of CHU Sahlou. No mention was made in the study of the type of healthcare personnel performing the phlebotomy procedures. The auditors scored each procedure according to five categories with multiple sub-categories. Compliance ranged from 20% (glove use) to 94% (patient prescribing and preparation).

• Patient prescribing and preparation (94.4% compliant);
• Equipment preparation (85.3% compliant);
• Hand hygiene (28.0% compliant);
• Glove use (20.0% compliant);
• Use of antiseptics (44.4% compliant);
• Collection procedure (45.1% compliant);
• Sample identification (64.3 % compliant);
• Laboratory worksheet (76.9% compliant);
• Transport (49.4% compliant).

The overall compliance rate was 57.7%. Ninety-one percent of all draws were successful on the first attempt. The results motivated the researchers to propose an improvement plan for blood collection procedures with the ultimate goal of improving the quality of care.

Read the study.