Abstract

Laboratory testing of blood samples is essential for the diagnosis and treatment of patients. This article aims to describe preanalytical errors in the clinical laboratory from a nursing management approach. Diagnostic tests are clinical decision support tools. Their use is said to be adequate or appropriate if the result answers the question that the clinician had asked himself before its request and, at the same time, if it helps him to decide some therapeutic action that benefits the patient. Venous blood collection is one of the most frequent nursing interventions in the ED, as well as a conclusive diagnostic test to establish a clinical judgment. Laboratory results have been estimated to affect up to 70% of the medical diagnosis, thus impacting the course of treatment and prognosis of patients. Therefore, it is necessary to have excellent quality control throughout the laboratory process to ensure that the results released to the clinician are reliable and truthful. In the pre-analytical process there is a wide variety of errors, these errors cover several areas; those related to the blood test request, i.e., that it is inadequate or incorrectly performed, lost or misidentified.

Abstract

Background: Venous blood collection is one of the most frequent nursing interventions in the emergency department, as well as a conclusive diagnostic test to establish clinical judgment.Aim: To describe factors affecting nursing organization and management in the practice of blood sampling.Methodology: The design was quantitative, observational, descriptive, cross-sectional, and included 50 nursing professionals from the neonatal and pediatric intensive care unit of a private hospital institution in the Autonomous City of Buenos Aires, from August 2019 to January 2020.Results: 80% of the respondents reported that there were no protocols or guidelines on blood collection for the laboratory. Most of the respondents (62%) were dissatisfied with the service provided by the laboratory. A statistically significant correlation was found between the time elapsed from obtaining the blood sample until the laboratory staff comes to pick them up, and the time taken by the laboratory to report the result of the analysis (r = 0.8857; P<0.0001; 95% CI r = 0.7717 to 0.9446).Conclusions: The need for standardization of the procedure is supported through a correct protocol that minimizes potential failures and allows the nursing professionals of the institution to homogenize knowledge, raising the quality of care and reducing health costs. The research identifies a lack of knowledge of the essential aspects of the preanalytical phase, which could affect the quality of the results provided by the clinical laboratory.