![[ Visit Client Website ]](images/banner.gif)
Learning Objective 1: Discuss incidence of hemolysis with IV starts vs. venipunctures
Learning Objective 2: Describe hemolysis effect on turnaround time in the Emergency Department setting
Setting: This study was conducted in a Level 2 ED of a 220-bed non-profit, teaching hospital. The ED volume was approximately 53,000 visits for fiscal year 2009.
Participants/Subjects: A convenience sample of 101 hemolyzed blood specimens drawn in the ED January, 2009- November, 2009 were included in this study, excluding specimens collected from minors, mastectomy, and dialysis patients.
Methods: IV site blood specimens were collected by randomly selected ED nurses with 2 or more years of ED experience, and the venipuncture specimens were collected by randomly selected ED technicians with 2 or more years of ED experience. Hemolyzed specimens were stratified according to method of specimen retrieval: Group A = venipuncture and Group B= IV site. Using SPSS, Chi-Square was used to compare the groups.
Results/Outcomes: Of the 101 hemolyzed specimens, 65 (64.4%) were drawn by newly placed 20g IV catheter, while 36 (35.6%) were drawn by 21-23g venipuncture needle. There was a significant difference in the proportion of hemolysis in the two specimen collection methods, x2 (1, N= 101) =8.327; p<.01.
Implications: A decreased hemolysis rate would result in improved ED throughput, reduced length of stay for the patient, and improved patient satisfaction. Based on these results and review of evidence from other sources, a policy was developed describing the process for obtaining blood specimens for laboratory patient testing in the ED.