Sammanfattning
Background: Clinical procedures and clinical guidelines have as the overarching goal to improve
patient safety and reduce errors. Lack of compliance increases the risk of delays, analytical errors
and misdiagnosis.
Methods: A structured checklist based on CLSI H3-A6 guidelines was used to observe venous blood
sampling in three hospitals in Norway. Sampling was done in various settings; an emergency
department, a clinical ward, an outpatient phlebotomy unit and in clinician’s offices. Three different
groups of health professionals were observed; biomedical laboratory scientists, nurses and medical
secretaries. To identify the most critical step in the blood sampling process a risk analysis was
conducted.
Results: A total of 108 observations were carried out. Average error rate was 26 %. Patient
identification and tube labelling were rated as the most critical steps in the sampling process.
Identification errors were most frequent in clinician’s offices and half of the medical secretaries
performing phlebotomy (51 %) did not identify patients according to recommended guidelines. The
errors related to test tube labelling policy was more prevalent in clinical wards (58 %) and at
clinician’s offices (36 %).
Conclusions: According to our results, the overall level of compliance of phlebotomy procedures with
CLSI H3-A6 guideline in Norway is low. The most critical steps were patient identification and tube
labelling.