{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T21:32:40Z","timestamp":1789680760075,"version":"4.0.1"},"reference-count":29,"publisher":"Croatian Society for Medical Biochemistry and Laboratory Medicine","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biochem. med. (Online)"],"published-print":{"date-parts":[[2020,6,15]]},"abstract":"<jats:p>Introduction: Poor compliance to the current guidelines and lack of knowledge among nurses about proper blood sampling is set as the study hypothesis. Here is presented a quality improvement project with following aims: a) to identify the most prevalent non-conformity of the samples for haemostasis testing, b) to identify the cause of sample non-conformity, c) to perform corrective action(s) and d) to assess the effectiveness of the corrective action(s). Materials and methods: The rate of non-conformity of samples collected for haemostasis tests was established for hospital wards with inpatients. Phlebotomy practice was audited throughout anonymous questionnaire among hospital\u2019s nurses who perform phlebotomy. Education about blood sampling was performed as a 1-hour lecture in different small groups each working day within one month. Education effectiveness was assessed through the evaluation of sample quality and is considered effective if more than half of the hospital wards significantly reduced their sample non-conformities rate. Results: Clotted sample constituted 84% of sample non-conformities. The questionnaire revealed nurses\u2019 poor knowledge in phlebotomy. There was no difference in nurses\u2019 knowledge regarding the level of education or work experience. Reduction in sample non-conformities was observed in 7 out of 9 wards 4 months after education; this improvement was statistically significant for 5 wards. Conclusion: Clotted sample as the most prevalent non-conformity of the samples for haemostasis testing is caused by the lack of knowledge of the nurses in several parts of the phlebotomy process. Specific education of the motivated personnel in small groups was successful and long-term effective.<\/jats:p>","DOI":"10.11613\/bm.2020.020708","type":"journal-article","created":{"date-parts":[[2020,6,10]],"date-time":"2020-06-10T14:06:01Z","timestamp":1591797961000},"page":"287-295","source":"Crossref","is-referenced-by-count":5,"title":["Quality improvement project: Reducing non-conformities of the samples for haemostasis testing in a secondary healthcare centre through the nurses\u2019 education in phlebotomy"],"prefix":"10.11613","volume":"30","author":[{"given":"Patricija","family":"Bankovi\u0107 Radovanovi\u0107","sequence":"first","affiliation":[{"name":"Department of transfusion medicine, General hospital Pula, Pula, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4885","published-online":{"date-parts":[[2020,6,14]]},"reference":[{"key":"key20200610100556_r1","doi-asserted-by":"crossref","first-page":"180","DOI":"10.21037\/atm.2018.04.02","article-title":"A Six-Sigma approach for comparing diagnostic errors in healthcare \u2013 where does laboratory medicine stand?","volume":"6","author":"Lippi","year":"2018","journal-title":"Ann Transl Med"},{"key":"key20200610100556_r2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1309\/LM749BQETKYPYPVM","article-title":"Pre-analytical variables in coagulation testing associated with diagnostic errors in hemostasis.","volume":"43","author":"Favaloro","year":"2012","journal-title":"Lab Med"},{"key":"key20200610100556_r3","doi-asserted-by":"crossref","first-page":"288","DOI":"10.2478\/jomb-2014-0043","article-title":"Laboratory diagnostics and quality of blood collection.","volume":"34","author":"Lima-Oliveira","year":"2015","journal-title":"J Med Biochem"},{"key":"key20200610100556_r4","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/j.cll.2007.12.007","article-title":"Quality improvement in laboratory medicine: extra-analytical issues.","volume":"28","author":"Lippi","year":"2008","journal-title":"Clin Lab Med"},{"key":"key20200610100556_r5","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1016\/j.clinbiochem.2013.04.028","article-title":"Role of quality management system in improving patient safety \u2013 laboratory aspects.","volume":"46","author":"Allen","year":"2013","journal-title":"Clin Biochem"},{"key":"key20200610100556_r6","unstructured":"ISO 15189 Quality management systems \u2013 Requirements for quality and competence, 3rd ed. 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Available at: https:\/\/www.changefactory.com.au\/our-thinking\/articles\/change-management-success-factors\/. Accessed on February 22nd,2020."},{"key":"key20200610100556_r20","doi-asserted-by":"crossref","first-page":"1987","DOI":"10.1515\/cclm-2016-0175","article-title":"Hemolysis rates in blood samples: differences between blood collected by clinicians and nurses and the effect of phlebotomy training.","volume":"54","author":"Cadamuro","year":"2016","journal-title":"Clin Chem Lab Med"},{"key":"key20200610100556_r21","doi-asserted-by":"crossref","first-page":"342","DOI":"10.11613\/BM.2012.036","article-title":"Impact of the phlebotomy training based on CLSI\/NCCLS H03-A6 \u2013 procedures for the collection of diagnostic blood specimens by venipuncture.","volume":"22","author":"Lima-Oliveira","year":"2012","journal-title":"Biochem Med (Zagreb)"},{"key":"key20200610100556_r22","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1515\/jomb-2017-0045","article-title":"The effects of education and training given to phlebotomists for reducing preanalytical errors.","volume":"37","author":"Arslan","year":"2018","journal-title":"J Med Biochem"},{"key":"key20200610100556_r23","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1309\/LMA4WYN3XFUKELBD","article-title":"Quality improvement in the coagulation laboratory: Reducing the number of insufficient blood draw specimens for coagulation testing.","volume":"46","author":"Bostic","year":"2015","journal-title":"Lab Med"},{"key":"key20200610100556_r24","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1186\/1472-6963-13-463","article-title":"Impact of a large-scale educational intervention program on venous blood specimen collection practices.","volume":"13","author":"B\u00f6lenius","year":"2013","journal-title":"BMC Health Serv Res"},{"key":"key20200610100556_r25","first-page":"911","article-title":"Reducing preanalytical laboratory sample errors through educational and technological interventions.","volume":"58","author":"Lillo","year":"2012","journal-title":"Clin Lab"},{"key":"key20200610100556_r26","article-title":"Personnel\u2019s experiences of phlebotomy practices after participating in an educational intervention programme.","volume":"2014","author":"B\u00f6lenius","year":"2014","journal-title":"Nurs Res Pract"},{"key":"key20200610100556_r27","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1515\/cclm-2012-0159","article-title":"Minor improvement of venous blood specimen collection practices in primary health care after a large-scale educational intervention.","volume":"51","author":"B\u00f6lenius","year":"2013","journal-title":"Clin Chem Lab Med."},{"key":"key20200610100556_r28","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.4102\/phcfm.v9i1.1242","article-title":"The effect of the phlebotomy training on blood sample rejection and phlebotomy knowledge of primary health care providers in Cape Town: A quasi-experimental study.","volume":"9","author":"Abbas","year":"2017","journal-title":"Afr J Prim Health Care Fam Med"},{"key":"key20200610100556_r29","doi-asserted-by":"crossref","first-page":"1585","DOI":"10.1515\/cclm-2013-0283","article-title":"Survey of national guidelines, education and training on phlebotomy in 28 European countries: an original report by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) working group for the preanalytical phase (WG-PA).","volume":"51","author":"Simundic","year":"2013","journal-title":"Clin Chem Lab Med"}],"container-title":["Biochemia medica"],"original-title":[],"link":[{"URL":"https:\/\/www.biochemia-medica.com\/en\/journal\/30\/2\/10.11613\/BM.2020.020708\/fullArticle","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T18:43:10Z","timestamp":1666896190000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.biochemia-medica.com\/en\/journal\/30\/2\/10.11613\/BM.2020.020708"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,14]]},"references-count":29,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,6,14]]},"published-print":{"date-parts":[[2020,6,15]]}},"URL":"https:\/\/doi.org\/10.11613\/bm.2020.020708","relation":{},"ISSN":["1846-7482","1330-0962"],"issn-type":[{"value":"1846-7482","type":"electronic"},{"value":"1330-0962","type":"print"}],"subject":[],"published":{"date-parts":[[2020,6,14]]}}}