Neonatal Intensive Care Unit Quality Initiative:  Identifying Preanalytical Variables Contributing to Specimen Hemolysis and Measuring the Impact of Evidence-Based Practice Interventions.

Abstract:

OBJECTIVES:Blood specimen hemolysis is a major cause of sample recollection in the neonatal intensive care unit. We aimed to reduce the hemolysis rate from 6.3% at baseline to less than 4% within the 9 months' duration of the study. METHODS:Intravenous infusion of lipid emulsion during sample collection, sample collection site, and blood sample transportation methods were investigated as possible contributors to hemolysis. Subsequently, two practice improvements were implemented: pausing lipid emulsion infusion prior to collection and slowing withdrawal rates through arterial catheters. RESULTS:Samples were more likely to be hemolyzed if they were collected during lipid infusion and subsequently transported by pneumatic tube or collected through an arterial catheter. Retrospective analysis demonstrated a decreased number of tests cancelled due to specimen hemolysis (3.5%) after our interventions. CONCLUSIONS:We identified three variables contributing to hemolysis and instituted two clinical practice interventions to significantly reduce test cancellations due to hemolysis.

journal_name

Am J Clin Pathol

authors

Tolan NV,Kaleta EJ,Fang JL,Colby CE,Carey WA,Karon BS,Baumann NA

doi

10.1093/ajcp/aqw086

subject

Has Abstract

pub_date

2016-07-01 00:00:00

pages

113-8

issue

1

eissn

0002-9173

issn

1943-7722

pii

aqw086

journal_volume

146

pub_type

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