Quality assurance

Quality Assurance in Phlebotomy

  • Definition of Quality Assurance (QA):A program that ensures quality patient care by tracking outcomes through scheduled audits.

    • Focus on appropriateness, applicability, and timeliness of patient care.

    • Continuous program established by healthcare facilities that includes guidelines, protocols, and continuing education for employees.

Phases of Quality Control in Phlebotomy

  • Three Main Areas:

    1. Pre Analytical:

      • Everything that occurs BEFORE the testing process, including collection and transportation of samples.

    2. Analytical:

      • Actual performance of laboratory testing during the testing process.

    3. Post Analytical:

      • Concerns storage of specimens and reporting of results after testing.

Responsibilities of Phlebotomists

  • Phlebotomists are primarily responsible for the pre analytical processes:

    • Tasks from reviewing patient orders to identifying the patient, collecting samples, and ensuring proper transportation to the lab.

    • Must ensure all actions are executed correctly to guarantee valid, accurate results.

Breakdown of Pre Analytical Processes

  • Three Distinct Phases of Pre Analytical Processes:

    1. Before Collection:

      • Preparation checks, ensuring patient compliance with pre-test preparations (e.g., fasting).

    2. During Collection:

      • Correct techniques and minimizing errors while drawing blood.

    3. After Collection:

      • Ensuring samples are properly labeled and transported for analysis.

Common Pre Analytical Errors

  • Pre analytical factors can lead to common errors that impact testing accuracy:

    • Before Collection: Miscommunication about required patient preparations.

    • During Collection: Errors in technique or sample handling.

    • After Collection: Incorrect labeling or mishandling of specimens.

Patient Preparation

  • Importance of Proper Patient Preparation:

    • QA begins before specimen collection. Proper patient readiness is essential for acceptable specimens.

    • Check for pre-test preparations through floor book in a hospital, or ask patients directly in outpatient settings.

    • Familiarize with the Laboratory Phlebotomy Specimen Collection Procedures Manual to understand specific guidelines for tests.

Verification of Patient Identity

  • Ensuring correct patient identification is crucial:

    • Phlebotomists must ask patients to state their name.

    • Utilize a second unique identifier: phone number, last four digits of social security number, or address.

    • Identification bands can be used as a secondary identifier but are not considered primary due to potential errors.

    • Avoid using patient charts or room numbers for identification; rely on verbal confirmation from the patient or a reliable party.

Conclusion

  • Phlebotomists hold significant responsibility in pre analytical processes, ensuring proper patient preparation and accurate identification to enhance quality assurance in laboratory testing.