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Compliance With Standards Linked to Workplace Factors

by Dennis Ernst • July 01, 2016

Standard on blocksHow closely do you adhere to the standardized phlebotomy procedure? It may depend on the size of your facility and how long you've worked there.

Researchers in Sweden set out to determine why some healthcare professionals adhere strictly to the established protocol and others don't. Questionnaires were completed by 164 healthcare professionals with blood collection responsibilities at 25 primary care centers asking them to self-assess their adherence to the established venipuncture procedure in regards to patient identification and sample labeling. Phlebotomy is Sweden is performed primarily by nurses, and clinical chemistry laboratory staff.

Participants were asked to rate their compliance with the following steps:

  • Item 1: Always ask patient to state name and civic number (national identification number)
  • Item 2: Never neglect asking for ID
  • Item 3: Always compare patient ID with ID on test request
  • Item 4: Always make sure test request and test tube label ID numbers are consistent

It was clearly articulated to all respondents to state how they usually performed venipunctures, not if they knew how it should be performed. Their response options were never, seldom, often, and always.

When the results were evaluated, females assessed themselves as more likely to be compliant with the suggested step than men on Items 1, 2, & 3. Those who worked for their employers for a for shorter time period assessed themselves higher than long-term employees, and participants working at larger facilities scored themselves to be more compliant than those at smaller work places. Those in urban settings also scored themselves higher than those in rural settings, as did those in federal facilities as opposed to private institutions. Those performing phlebotomy every week or less were more likely to adhere than those who draw blood daily.

The size of the facilities employing those who participated were classified as follows:

  • Small---1-19 employees
  • Medium---20-34 employees
  • Large---35+ employees

The authors speculate those who were employed at their facilities five years or longer demonstrated lower self-assessment scores on patient identification procedures because they have had more time to interact with coworkers and develop their own shared policies contrary to the established protocol and degree of acceptance of their collective divergence. According to the authors, long-term employees "had plenty of time to develop their own sets of prevailing truths" about the venipuncture procedure.

Read the full study.


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