Order of draw practices in venous blood sampling at clinical biochemistry departments in the Danish health care system

Katja Kemp Jacobsen*, Ida Brandt, Anne Vindahl Christensen, Bjørk Anine Rimsø, Camilla Julie Krøier, Michelle Sørensen, Julie Smith, Kathrine Overgaard Foss Jensen, Jeppe Madura Larsen

*Corresponding author for this work

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Abstract

BACKGROUND: Deviation in blood collection procedures is a central source of preanalytical variation affecting overall analytical and diagnostic precision. The order of draw of venous sampling is suspected to affect analytical results, in particular for coagulation analysis. Here we compare the procedures in venous blood sampling among clinical biochemistry departments to assess the uniformity of order of blood draw and adherence to international guidelines in the Danish health care system.

METHODS: We collected venous order of draw procedures from 49 clinical biochemistry departments at 22 public hospitals in Denmark. Procedures were compared to the international guidelines fromthe Clinical Laboratory Standards Institute (CLSI) and World Health Organization (WHO), and assessed in relation to department ISO 15189:2012 accreditation.

RESULTS: We observed seven different order of draw procedures related to citrate, serum, heparin, and EDTA tubes, and the use of discard tubes in relation to coagulation assays. 31 departments (63.3%) were found to adhere to CLSI and WHO guidelines. A majority of departments instructs the use of discard tubes before collection for coagulation assays in citrate tubes (44 departments; 89.8%). The citrate tube was the first sample tube to be drawn for most departments (35 departments; 75.5%); and the preferred order of non-citrate tubes was serum-heparin-EDTA (36 departments; 73.5%). Adherence to the CLSI and WHO guidelines was not associated with department ISO 15189:2012 accreditation (p = .57).

CONCLUSIONS: Venous order of draw procedures is diverse at Danish clinical biochemistry departments and show moderate adherence to international guidelines.

Original languageEnglish
JournalClinical Biochemistry
Volume56
Pages (from-to)113-116
ISSN0009-9120
DOIs
Publication statusPublished - 20 Apr 2018

Keywords

  • Venous blood sampling
  • Order of blood draw
  • Phlebotomy
  • Preanalytical phase
  • Preanalytical quality
  • Inter-laboratory variation

Cite this

Jacobsen, Katja Kemp ; Brandt, Ida ; Christensen, Anne Vindahl ; Rimsø, Bjørk Anine ; Krøier, Camilla Julie ; Sørensen, Michelle ; Smith, Julie ; Jensen, Kathrine Overgaard Foss ; Larsen, Jeppe Madura. / Order of draw practices in venous blood sampling at clinical biochemistry departments in the Danish health care system. In: Clinical Biochemistry. 2018 ; Vol. 56. pp. 113-116.
@article{aefb793d3ffd46cfab4558588cafd28a,
title = "Order of draw practices in venous blood sampling at clinical biochemistry departments in the Danish health care system",
abstract = "BACKGROUND: Deviation in blood collection procedures is a central source of preanalytical variation affecting overall analytical and diagnostic precision. The order of draw of venous sampling is suspected to affect analytical results, in particular for coagulation analysis. Here we compare the procedures in venous blood sampling among clinical biochemistry departments to assess the uniformity of order of blood draw and adherence to international guidelines in the Danish health care system.METHODS: We collected venous order of draw procedures from 49 clinical biochemistry departments at 22 public hospitals in Denmark. Procedures were compared to the international guidelines fromthe Clinical Laboratory Standards Institute (CLSI) and World Health Organization (WHO), and assessed in relation to department ISO 15189:2012 accreditation.RESULTS: We observed seven different order of draw procedures related to citrate, serum, heparin, and EDTA tubes, and the use of discard tubes in relation to coagulation assays. 31 departments (63.3{\%}) were found to adhere to CLSI and WHO guidelines. A majority of departments instructs the use of discard tubes before collection for coagulation assays in citrate tubes (44 departments; 89.8{\%}). The citrate tube was the first sample tube to be drawn for most departments (35 departments; 75.5{\%}); and the preferred order of non-citrate tubes was serum-heparin-EDTA (36 departments; 73.5{\%}). Adherence to the CLSI and WHO guidelines was not associated with department ISO 15189:2012 accreditation (p = .57).CONCLUSIONS: Venous order of draw procedures is diverse at Danish clinical biochemistry departments and show moderate adherence to international guidelines.",
keywords = "Venous blood sampling, Order of blood draw, Phlebotomy, Preanalytical phase, Preanalytical quality, Inter-laboratory variation",
author = "Jacobsen, {Katja Kemp} and Ida Brandt and Christensen, {Anne Vindahl} and Rims{\o}, {Bj{\o}rk Anine} and Kr{\o}ier, {Camilla Julie} and Michelle S{\o}rensen and Julie Smith and Jensen, {Kathrine Overgaard Foss} and Larsen, {Jeppe Madura}",
note = "Copyright {\circledC} 2017. Published by Elsevier Inc.",
year = "2018",
month = "4",
day = "20",
doi = "10.1016/j.clinbiochem.2018.04.020",
language = "English",
volume = "56",
pages = "113--116",
journal = "Clinical Biochemistry",
issn = "0009-9120",
publisher = "Elsevier",

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Jacobsen, KK, Brandt, I, Christensen, AV, Rimsø, BA, Krøier, CJ, Sørensen, M, Smith, J, Jensen, KOF & Larsen, JM 2018, 'Order of draw practices in venous blood sampling at clinical biochemistry departments in the Danish health care system', Clinical Biochemistry, vol. 56, pp. 113-116. https://doi.org/10.1016/j.clinbiochem.2018.04.020

Order of draw practices in venous blood sampling at clinical biochemistry departments in the Danish health care system. / Jacobsen, Katja Kemp; Brandt, Ida; Christensen, Anne Vindahl; Rimsø, Bjørk Anine; Krøier, Camilla Julie; Sørensen, Michelle; Smith, Julie; Jensen, Kathrine Overgaard Foss; Larsen, Jeppe Madura.

In: Clinical Biochemistry, Vol. 56, 20.04.2018, p. 113-116.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Order of draw practices in venous blood sampling at clinical biochemistry departments in the Danish health care system

AU - Jacobsen, Katja Kemp

AU - Brandt, Ida

AU - Christensen, Anne Vindahl

AU - Rimsø, Bjørk Anine

AU - Krøier, Camilla Julie

AU - Sørensen, Michelle

AU - Smith, Julie

AU - Jensen, Kathrine Overgaard Foss

AU - Larsen, Jeppe Madura

N1 - Copyright © 2017. Published by Elsevier Inc.

PY - 2018/4/20

Y1 - 2018/4/20

N2 - BACKGROUND: Deviation in blood collection procedures is a central source of preanalytical variation affecting overall analytical and diagnostic precision. The order of draw of venous sampling is suspected to affect analytical results, in particular for coagulation analysis. Here we compare the procedures in venous blood sampling among clinical biochemistry departments to assess the uniformity of order of blood draw and adherence to international guidelines in the Danish health care system.METHODS: We collected venous order of draw procedures from 49 clinical biochemistry departments at 22 public hospitals in Denmark. Procedures were compared to the international guidelines fromthe Clinical Laboratory Standards Institute (CLSI) and World Health Organization (WHO), and assessed in relation to department ISO 15189:2012 accreditation.RESULTS: We observed seven different order of draw procedures related to citrate, serum, heparin, and EDTA tubes, and the use of discard tubes in relation to coagulation assays. 31 departments (63.3%) were found to adhere to CLSI and WHO guidelines. A majority of departments instructs the use of discard tubes before collection for coagulation assays in citrate tubes (44 departments; 89.8%). The citrate tube was the first sample tube to be drawn for most departments (35 departments; 75.5%); and the preferred order of non-citrate tubes was serum-heparin-EDTA (36 departments; 73.5%). Adherence to the CLSI and WHO guidelines was not associated with department ISO 15189:2012 accreditation (p = .57).CONCLUSIONS: Venous order of draw procedures is diverse at Danish clinical biochemistry departments and show moderate adherence to international guidelines.

AB - BACKGROUND: Deviation in blood collection procedures is a central source of preanalytical variation affecting overall analytical and diagnostic precision. The order of draw of venous sampling is suspected to affect analytical results, in particular for coagulation analysis. Here we compare the procedures in venous blood sampling among clinical biochemistry departments to assess the uniformity of order of blood draw and adherence to international guidelines in the Danish health care system.METHODS: We collected venous order of draw procedures from 49 clinical biochemistry departments at 22 public hospitals in Denmark. Procedures were compared to the international guidelines fromthe Clinical Laboratory Standards Institute (CLSI) and World Health Organization (WHO), and assessed in relation to department ISO 15189:2012 accreditation.RESULTS: We observed seven different order of draw procedures related to citrate, serum, heparin, and EDTA tubes, and the use of discard tubes in relation to coagulation assays. 31 departments (63.3%) were found to adhere to CLSI and WHO guidelines. A majority of departments instructs the use of discard tubes before collection for coagulation assays in citrate tubes (44 departments; 89.8%). The citrate tube was the first sample tube to be drawn for most departments (35 departments; 75.5%); and the preferred order of non-citrate tubes was serum-heparin-EDTA (36 departments; 73.5%). Adherence to the CLSI and WHO guidelines was not associated with department ISO 15189:2012 accreditation (p = .57).CONCLUSIONS: Venous order of draw procedures is diverse at Danish clinical biochemistry departments and show moderate adherence to international guidelines.

KW - Venous blood sampling

KW - Order of blood draw

KW - Phlebotomy

KW - Preanalytical phase

KW - Preanalytical quality

KW - Inter-laboratory variation

U2 - 10.1016/j.clinbiochem.2018.04.020

DO - 10.1016/j.clinbiochem.2018.04.020

M3 - Journal article

VL - 56

SP - 113

EP - 116

JO - Clinical Biochemistry

JF - Clinical Biochemistry

SN - 0009-9120

ER -