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Updated: Aug 28, 2025
Rapid Fractionation and Isolation of Whole Blood Components in Samples Obtained from a Community-based Setting
Published on: November 30, 2015
Simple signature/countersignature shared-accountability quality improvement initiative to improve reliability of
Chenwei Wu1,2, Chatty O'Keeffe3, Jesse Sanford3
1Hospital and Specialty Medicine, VA Puget Sound HCS Seattle Division, Seattle, Washington, USA chenwei.wu2@va.gov.
Background:
Timely lab results are important to clinical decision-making and hospital flow. However, at our institution, unreliable blood sample collection for patients with central venous access jeopardised this outcome and created staff dissatisfaction.
Methods:
A multidisciplinary team of nurses including a specialist clinical nurse leader (CNL), the hospital intravenous team and quality improvement (QI) consultants aimed to achieve >80% blood sample collection reliability among patients with central venous access by employing a simple signature/countersignature form coupled with audit-feedback and behavioural economics strategies. The form was piloted on one 25-bed unit. Data were collected for 60 weeks and interpreted per standard run chart rules.
Results:
Blood sample collection reliability exceeded the 80% goal by week 22. The practice was sustained on the pilot unit and spread successfully to other wards despite significant operational threats including the COVID-19 pandemic.
Conclusions:
At our institution, a simple signature/countersignature form supplemented by audit-feedback and behavioural economics strategies led to sustained practice change among staff. The pairing of CNL to QI consultant enhanced change potency and durability.
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