Education Found Effective in Improving Venipunctures
Researchers in Denmark recently proved the obvious: educating your staff improves their adherence to the proper venipuncture procedure.
Thirty-nine phlebotomists were observed drawing 126 patients and their compliance with a checklist recorded. The most frequently committed error was improper hand hygiene (42 percent), followed by failure to follow the correct order of draw (19 percent), and improper sample mixing (21 percent).
Significant improvement was seen for all three in regards to all three error frequencies. Those performing improper hand hygiene decreased from 42 percent to 10 percent; improper tube mixing decreased from 19 percent to 3 percent); and the rate of those filling tubes in the wrong order of draw declined from 21 percent to 12 percent..
According to the authors, controlling preanalytic quality by observational analysis is an effective way to identify critical issues in the blood sampling procedure. They also concluded corrective actions, especially in the form of educational activities, results in better adherence to the established protocol for collection blood samples.
Read the full study.
Spending Down? Videos Now Half Price Through December
The six-set Applied Phlebotomy Lecture Collection is now half-price. Titles include:
- Seizing Control of Blood Culture Contamination Rates
- Ending Hemolysis in the ED... and Everywhere Else
- Mastering Pediatric Phlebotomy
- Potassium Results Your Physicians Can Trust
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- Successful Strategies for Difficult Draws
Sale ends December 31, 2016.
What Should We Do?: Identity crisis
In our clinic lab, we are all credentialed professionals (MLT, MLS, etc.). The ID badges personnel wear state RN or LPN in large, bold letters. But the lab personnel's badges merely state "Clinic." Our patients have commented that the badges are confusing as to what our actual roles are. We've shared our disappointment to managers both verbally and with employee surveys, but nothing changes. We indeed feel "devalued" by our employer, but don't know what else we can do to change their indifference and the generalizing of our role here. What should we do?
Our response: You certainly are entitled to have your professional credentials proudly displayed on your badges, and your role in the clinic clearly defined to your patients. It's disturbing that the established avenues for improving the workplace (personal communication with managers and employee surveys) are being ignored. Although employee recognition is a key concept in human resource management, it's importance is often overlooked until it's too late to salvage morale. Rest assured it's already eroding in your facility. Not only that, but it's become a customer service problem since your patients are confused about your staff.
Cost cannot be the factor here, since we're talking about a simple, cheap fix. A deeper conversation is in order with your management team. Explain the frustration is not just yours, but permeates the entire department, and that the problem has now multiplied. Not only does the lab staff feel management doesn't care about their professional credentials, now they question whether management cares about any of their concerns. Failure to address this problem will soon make it multiply again, this time in the form of friction between the two professions. This won't end well unless it's addressed.
Ask for permission to take the project on yourself, and get the badges corrected for your staff. It could just be the manager is overwhelmed with responsibilities and not good at delegating. However, that won't solve the problem of comments being put into the employee suggestion box and not addressed. There's a breakdown in that process somewhere that needs to be found and fixed as well. Perhaps you should offer to take that on as well. That's how promotions happen.
The Empowered Healthcare Manager
Every month we run an excerpt from our editor's popular blog, The Empowered Healthcare Manager.
Explosions and Implosions
Implosions occur when there's too much energy on the outside of a building for it to support, and it collapses onto itself. Explosions occur when there's too much energy inside a building and it rapidly erupts outward in every direction.
Workplaces are a lot like buildings.
There are six energies an empowered manager coaxes from his/her staff that collectively lead to an explosion: synergy, camaraderie, harmony, unity, quality and creativity. Sooner or later the building cannot contain the energy. The place erupts with growth, progress, and buzz.
Conversely, mere managers coax other energies---intentionally and by neglect---that lead to an implosion. They include dissent, discontent, demoralization, indifference, and dissonance.
Employees who dissent from the mission regress into passive discontent and indifference. Some become actively discontent and act out as gossips, bullies, and saboteurs. Sooner or later the building cannot contain the negative energy and the structure implodes, collapsing on itself like a house of cards.
The empowered manager soon empowers the facility to do things that would not otherwise be possible; namely, expand in the marketplace.
The dysfunctional manager soon enables the facility to do what would not otherwise be possible; namely, contract into irrelevance.
Subscribe to the Empowered Healthcare Manager blog.
Product Spotlight: The Phlebotomy Channel
Why assemble your staff and trainees in one room to watch a DVD when you can assign them to watch the streaming version at their convenience? Freeing yourself up to accomplish your more pressing tasks is good time management.
Why worry about losing your only copy of the DVD everyone else wants to borrow. Streaming videos can't get lost or damaged.
Once you subscribe to the Phlebotomy Channel, you'll not only get more productive, you'll get:
Seventeen of the most popular phlebotomy training videos on the planet;
Instant access anytime anywhere;
The most current versions, even when the industry standards change;
An insanely affordable cost-per-view .
As this year ends, get your staff and students the gift that keeps on playing. An All-Access Pass to the Phlebotomy Channel streams the most up-to-date and engaging phlebotomy training videos in the marketplace. See why schools and hospitals around the world trust the Phlebotomy Channel to flawlessly deliver high-caliber training videos on demand.
Plus, with real-time tracking, you'll get a full report on who watched the videos you assigned and when. You'll also be able to assess their comprehension with the CE quiz accompanying every title.
Check out the full-length previews we've posted for every title as well as a promotional video highlighting the features we've build into the platform at www.phlebotomy.com/PCTV.cpe.
Start streaming. You'll be amazed how convenient it is.
Survey Says: Tube labeling practices
Last month we wanted to know what your tube labeling practices are. It seems to have been an issue you've been wanting to talk about, since it was one of our biggest survey ever in terms of participants.
First we asked if you ever labeled tubes you didn't draw. Sixty percent said they never do, but 36 percent admitted they will label tubes they don't draw only if they witness the collection including the patient identification step.
Next, we wanted to know, of the tubes you draw yourself, do you ever label them away from the patient. A full 81 percent said they never label away from the patient, but 18 percent said they sometimes do. One person said they never label in the presence of the patient.
Then we asked if you ever label tubes before they are filled. and if you think it's an acceptable practice. Seventy-nine percent of you said you never pre-label tubes, while seven percent said you do because it's acceptable where you work. Fourteen percent said they don't even though it's acceptable at their facilities. It's important to note pre-labeling tubes goes against the CLSI standards.
Regardless of the policy at their facilities, almost 90 percent said pre-labeling should not be acceptable. Here are some of your comments:
- What if you miss a tube and someone else uses it in error?
- A patient died in my home city because of this a few years ago. Never ever prelabel tubes.
- We used to pre label tubes but we found that there were too many errors and we also found staff discharged patients too quickly. Apart from the safety of labelling the tubes afterwards, it requires longer post-venepuncture care and the wound care is improved as a bonus.
- There are times I think it may be acceptable to label tubes prior to collecting as long as the patient is able to verify the labels on the tubes.
- If the tube is prelabeled and no blood is collected then another label has to be reprinted in order to put it on the tube that was collected on the second attempt.
- Yes, but only for isolation patients as it is infection control policy. I have never been comfortable with it and I protested against it when the new infection control policy was brought in.
- It's NEVER acceptable!
- I also have the patient/parent spell first & last name, state birthday precollection, and everyone in the room old enough to read (patient/family/nurses) check the tube labels post collection.
- Yes, but the labeled tubes are matched against the ID band before leaving or dismissing the patient.
- Saw someone get fired for this my first year on the job and have NEVER done this.
- Although I know it's not good practice, when bleeding in the outpatient area and I'm collection 5+ tubes, I will label the first few, check and release the patient, then label the rest at the same station. Mainly this is because we hand-write on our tubes and this makes a long time for patients to be waiting, and they tend to get disgruntled. I never move from where I have been working however. In the wards though I never label away from patient and have even made doctors and nurses wait while I label at bedside.
- Some patients just up and walk away while I'm labeling tubes.
- If they leave the draw station before I'm done then yes but I don't start something else or leave the impatient room
- At the medical group where I work, at times patients have had 12 or more tubes drawn in one sitting. I have started the labeling process in front of them, but they are too antsy and leave.
- I have them put pressure on the site while I label the tubes. Then I know pressure was put on it for an adequate amount of time.
This month, we're asking what strategies do you use to reduce the pain of pediatric phlebotomy and calm the fears of pediatric and adult patients. Take the survey.