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Specimen collection volumes for laboratory tests.

Jane C Dale1, Stephen G Ruby

  • 1Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA. dale.jane@mayo.edu

Archives of Pathology & Laboratory Medicine
|February 4, 2003
PubMed
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Hospitals can reduce blood wastage and iatrogenic anemia by optimizing specimen collection volumes. Using smaller collection tubes significantly decreases overcollection and discard volumes for routine laboratory tests.

Area of Science:

  • Clinical Pathology
  • Laboratory Medicine
  • Patient Safety

Background:

  • Iatrogenic anemia in hospitalized patients stems from unnecessary tests, inefficient ordering, and excessive blood collection.
  • Accredited laboratories are expected to periodically review phlebotomy practices for specimen collection volumes.

Purpose of the Study:

  • To report specimen collection, analytic, and discard volumes for routine laboratory tests.
  • To identify practice variables associated with overcollection and blood wastage.

Main Methods:

  • 140 institutions participated in the College of American Pathologists Q-Probes program.
  • Data collected included collection container size, requested volume, analytic volume, and discard volume for complete blood cell counts and electrolyte panels.

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  • Questionnaires gathered information on specimen collection, processing, and analytic practices.

    • Main Results:

    • Laboratories collected significantly more blood than instrument analytic volumes for routine tests (e.g., 8.5 times more for CBCs).
    • Overcollection and discard volumes were directly associated with specimen collection container size.
    • Instrument analytic volume did not determine blood wastage.

    Conclusions:

    • Laboratories can decrease collection volumes without impacting reliable test results.
    • Utilizing smaller collection tubes is an effective strategy to reduce blood wastage.