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Related Experiment Video

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Rapid Fractionation and Isolation of Whole Blood Components in Samples Obtained from a Community-based Setting
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Increased specimen minimum volume reduces turnaround time and hemolysis.

Abraham J Qavi1, Caroline E Franks2, Gary Grajales-Reyes1

  • 1Department of Pathology & Immunology, Washington University, School of Medicine, St. Louis, MO, United States.

Clinical Biochemistry
|March 30, 2022
PubMed
Summary

Low blood volume in laboratory specimens significantly increases testing time and sample hemolysis. Implementing a minimum 1.5 mL volume policy, alongside provider education, effectively reduced turnaround times and hemolysis, improving specimen quality.

Keywords:
HemolysisShort samplesTurn-Around-Time

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Area of Science:

  • Clinical Laboratory Science
  • Medical Diagnostics
  • Healthcare Quality Improvement

Background:

  • Quantity not sufficient (QNS) specimens with minimal blood volume are frequent in clinical labs.
  • Lack of a universal definition for QNS and limited data on low-volume specimen impact on TAT and hemolysis exist.

Purpose of the Study:

  • To assess the impact of low blood volume (≤1.0 mL) on laboratory turnaround time (TAT) and sample hemolysis.
  • To evaluate the effectiveness of a new QNS policy requiring a minimum of 1.5 mL blood sample volume.

Main Methods:

  • Compared TAT and hemolysis index for specimens ≤1.0 mL versus all specimens.
  • Implemented a new QNS policy (≥1.5 mL minimum volume) and assessed its impact on sample hemolysis and TAT.
  • Quantified the number of specimens with reduced blood volume.

Main Results:

  • Median TAT for samples ≤1.0 mL was 61 min vs. 28 min for all samples.
  • Hemolysis index for samples ≤1.0 mL was 112 vs. 15 for all samples.
  • The 1.5 mL minimum volume policy reduced TAT ≥60 min from 10.4% to 4.24% in the ED and decreased hemolysis-related cancellations.

Conclusions:

  • Limited specimen volume is correlated with increased laboratory TAT and hemolysis.
  • Implementing a minimum 1.5 mL QNS policy and provider education significantly reduced TAT and specimen hemolysis.
  • The policy demonstrated a durable positive effect on laboratory efficiency and specimen quality.