Reducing Phlebotomy in Hemodialysis Patients: A Quality Improvement Study

Area of Science:

• Nephrology
• Quality Improvement
• Health Informatics

Background:

• Hospitalized patients on hemodialysis often undergo frequent peripheral venipunctures for laboratory tests.
• These venipunctures can be painful, damage peripheral veins, and compromise future dialysis access.
• Drawing blood from the hemodialysis circuit offers a potential alternative to reduce these venipunctures.

Purpose of the Study:

• To implement and evaluate an initiative to encourage blood draws during hemodialysis sessions.
• To reduce the number of unnecessary peripheral venipunctures in hospitalized hemodialysis patients.
• To assess the feasibility and initial impact of drawing blood

Main Methods:

• A quality improvement study was conducted with non-critically ill adult hemodialysis patients.
• The electronic health record was modified to enable ordering laboratory studies
• with dialysis
• frequency.
• Educational outreach promoted the use of this ordering option among healthcare providers.

Main Results:

• During the first year, an average of 6.3
• with dialysis
• blood draws were performed per 100 eligible patients weekly.
• The initiative resulted in estimated cost savings exceeding $7,000 in the first year.
• The study demonstrated successful integration of a new blood draw protocol.

Conclusions:

• Implementing
• with dialysis
• blood draws is a viable quality improvement strategy.
• This approach can prevent unnecessary peripheral venipunctures and preserve vascular access in hemodialysis patients.
• Further efforts are needed to increase adoption and track broader outcomes.