[The effect of tailored training courses in preanalytical procedures on the quality of laboratory results]

In 31 to 75 percent of cases, errors in laboratory medicine have preanalytical causes such as erroneous blood sampling. Erroneous blood sampling may lead to false test results and additional laboratory cost; it may increase analyzing time and endanger the health of patients and employees. In particular, under- and overfilling of blood sampling tubes can considerably distort laboratory values. So far there has been a lack of studies investigating the effect of a tailored training for ward staff to improve preanalytical procedures on blood sampling.

Can a tailored preanalytical training significantly reduce the number of commented under- and overfilled coagulation samples, reduce the number of hemolytic serum and lithium heparin samples and increase the number of standards-compliant blood sampling?

In an intervention study we compared the number of commented under- and overfilled coagulation tubes and the number of hemolytic serum and lithium heparin samples on the basis of laboratory data and, using participant observation, compared the blood sampling quality on a surgical ward before and after participation in a training course. Based on prior results of participant observation, a 20-minute training was conceptualized and conducted. Target criteria were a) the number of commented under- and overfilled coagulation tubes and b) the number of hemolytic serum and lithium heparin samples in a before/after comparison (Oct-Dec 2017 and Jan-Mar 2018 compared with Jun-Aug 2018) and an annual comparison (Jun-Aug 2017 compared to Jun-Aug 2018), and c) a standards-compliant performance of blood sampling in a before/after comparison (Apr 2018 and Jun 2018). The number of commented under- and overfilled coagulation tubes in the annual comparison was compared using the Chi-square test.

After the training (Jun-Aug 2018) the number of commented under- and overfilled coagulation tubes decreased significantly in annual comparison to Jun-Aug 2017 (-68.07%, p < 0.001). The number of commented under- and overfilled coagulation tubes and of hemolytic serum and lithium heparin samples decreased in the before/after and in the annual comparison, and the number of standards-compliant blood samplings increased in the before/after comparison.

The training contributed significantly to reducing the number of commented coagulation samples and hemolytic serum and lithium heparin samples and to increasing standards-compliant blood sampling. There is a need to investigate to what extent this concept can be transferred to other wards, and in which intervals further trainings should be conducted in order to maintain these positive effects.