We conducted three focus group interviews with registered nurses that perform blood sampling collections from children. Watson ID, Wilkie P, Hannan A, Beastall GH. Lee H, Lee H, Kim C, Shin H, Lee I, Kim Y. J Pers Med. anticoagulant or preservative for Heel pricks, which are specifically for infants. (Nurses Group 2). non-penetrating like plastic, closable, leak proof Pediatrics. They could not believe it when the blood sample came back from the laboratory as a failed analysis, which created stress, anger and frustration. They were also worried that all this sampling could lead to risk of hospital-acquired anaemia. fill its own level. Qual Health Res. Geneva: World Health Organization; 2010. The nurses described how it felt to lack knowledge of paediatric care and mentioned what they had missed out on during their introduction programs or even university nursing education. Molecules. Unfortunately, the pre-analytical phase in blood sampling collection from children has been found to be commonly affected by pre-analytical errors, which could risk patient safety and comfort [4]. syringes. The subtheme Nurses believe in team work illustrates that the nurses searched for ways to cope with the complex blood sampling procedure and did so by communicating with parents and gathering colleagues in the team. The first author (HH) has deep knowledge and understanding of the given subject, which was a resource for the interpretation of the data. We chose not to return the transcript (item 23) to the participants after the interviews, as we had not taken notes on who said what in the group. Provided by the Springer Nature SharedIt content-sharing initiative. Unauthorized use of these marks is strictly prohibited. Back care in nursing anjalatchi 74.2K views36 slides. collection and needle inserted, Blood culture sample collected in The nurses said that when patients had a new existing cannula, it made things more pleasant for both them and the child, as they could continuously withdraw samples without punctures and pain for the child. thoroughly, Record the procedure in the nurses The narrative results of this study illustrate that nurses working in paediatric hospital care face a big challenge in blood sampling children. Bookshelf FOIA Getting the right amount of blood for the ordered analyses was another aspect discussed in regard to choosing the right method. The four subthemes: Nurses feelings of frustration with unsuccessful samplings, Nurses believe in team work, Venous blood sampling was experienced as the best option and Nurses thoughts and needs regarding skills development in paediatric blood sampling describe the nurses diverse experiences concerning blood sampling in children. official website and that any information you provide is encrypted and transmitted securely. This is pertinent to the role of nurses working in Swedish paediatric hospitals, who must have knowledge, skills and specific competence concerning blood sampling procedures, which include preparations and support adapted to each individual childs development [17]. The United Nations childrens convention from 1989 confirmed the rights of children to be supported, protected and respected, and for them to participate with their dignity recognised. pulling the plunger of the syringe gently. Terms and Conditions, [Transfusions in the elderly: peculiarities and the role of nurses]. (Nurses Group 3). and techniques are used in collection, storage, transport of blood sample, Preparation of the Patient and Environment. before antibiotics are administered, The doctors order for specific Therefore, the aim of this study therefore was to describe paediatric nurses' experiences of blood sampling collections from children. Hemolysis Control in the Emergency Department by Interventional Blood Sampling. Qualitative research & evaluation methods: integrating theory and practice. Federal government websites often end in .gov or .mil. The interviews were conducted in comfortable and nicely spaced conference rooms close to the clinic, which aimed to create a relaxed and peaceful environment for the interviews. with lavender or green tops contain Throat Swab Culture 2. Everything went perfectly, and then the haemolysis, you just go what?! Kennedy C, Angermuller S, King R, Noviello S, Walker J, Warden J, Vang S. J Emerg Nurs. NSP 048 V03 To achieve credibility, it is crucial to find participants who are likely to have experiences of the phenomenon under study and are able to talk about it [47]. Over several months of nurse collection, the pilot was very successful. BMC Med Ethics. labeled according to policy with appropriate PubMedGoogle Scholar. A purposeful sampling also means you want to identify informative participants to generate rich informative data and in-depth information about the particular phenomena you want to investigate [25]. as culture bottles, etc, Obtain laboratory request and culture This study used focus groups, which is a method that could give the researcher a certain depth of data and context. to the culture bottles, Clean the culture bottle led with culture bottle, Choose the vein to be drawn by should be used for collection of blood, The top of the bottle must be The focus groups included registered paediatric nurses with different levels of experience and education. Acta Paediatr. The nurses said venous sampling could benefit the blood flow and increased the chances of capturing good quality blood specimens. 2007;53(7):133842. Cite this article. The interviews lasted between 3958min and were audio recorded. One hospital is a tertiary hospital with oncology, surgical, medical and intensive care units, while the second hospital is smaller regional hospital, with two medical wards. volume21, Articlenumber:62 (2022) Do not remove needles from disposable Bolenius K, Brulin C, Graneheim UH. immediately to the laboratories, Remove the gloves and wash hands Another subtheme was Venous blood sampling was experienced as the best option. J Pediatr Nurs. This article explores the complex factors that can influence clinical decisions and enhance patient safety in the administration of blood components, particularly red blood cell transfusions in patients with anaemia. The nurses felt that both physical and psychological support from each other were essential for a qualitative sampling procedure. Lavoie P, Michaud C, Belisle M, Boyer L, Gosselin E, Grondin M, et al. Braun V, Clarke V. Novel insights into patients life-worlds: the value of qualitative research. Yes, but it feels disappointing. collection. Preisz A, Preisz P. Restraint in paediatrics: A delicate balance. Record medical history and symptoms. Remove the torniquet as soon as blood possible. 2018;74(2):23950. One of the core responsibilities of nurses is to collect, then label specimens for analysis. 2008;122(Suppl 3):S1303.https://doi.org/10.1542/peds.2008-1055e. Careers. Patton MQ. liquid K3 EDTA anticoagulant or The organisation of data went through the six described phases, including transcribing, making notes and coding, and creating themes composed from code patterns and meaning of data [28]. ml for adult, 2-5 ml for children and 1-2 ml for infants and neonates, Blood for culture should be taken Specimen collection Manju Mulamootll Abraham 98.5K views49 slides. Not just to have fewer needlings but also because you might not have that many chances to take, in the first instance, venous samples theyve kind of got a certain number of vessels that are even possible to try on. The first focus group stated that, in future, they would like an annual continuous professional development course in sampling techniques. Careers. When sharp box reaches full close, tape, date Each interview started with open-ended questions and followed by probing questions to elicit more elaborative answers [25]. the patient, Articles available in the unit such 2017;35(3):28095. Such interventions would help nurses increase their competence as well as understand why sampling procedures fail and how this can be avoided. kill the particular microorganism, When the patient has chills or a Of these, 28 intravenous catheter samples (5.6%) were found to be hemolyzed, whereas only 1 venipuncture sample (0.3%) was hemolyzed. Coyne I, Scott P. Alternatives to restraining children for clinical procedures. Blood sample quality. 2019;57(1):13442. Hjelmgren, H., Ygge, BM., Nordlund, B. et al. of blood for blood culture is a sterile procedure. 2018;5(3):3939. The National Society for Pediatric Nurses & the Swedish Nurses' Association 2016. They mentioned that they were able to ask for help and, if necessary, they could spontaneously change blood sampling method or even who was in charge of the needling. culture bottle, Mix the solution and blood gently by The chiasm: transfusion practice versus patient blood management. Some participants also felt important information had been omitted about the differences between paediatric and adult blood sampling procedures and that university nursing programs had failed to mention this in their training. To detect the microorganisms ; To treat the disease condition with correct antibiotics ; To detect the right antibiotic to kill the particular microorganism Transfus Med. Moreover, children state that needle procedures are the worst experience of their hospital stay. 10.7748/ns.2021.e11671 Abstract Patient blood management has been defined as a patient-focused and evidence-based approach to optimising the management of patients during the transfusion of blood components. The blood sampling process is a multilevel process that includes nursing care, laboratory medicine and medicine science, and this makes cooperation and communication for the patients best especially important [46]. Clinical implications of unmanaged needle-insertion pain and distress in children. In regard to capillary sampling, one participant explained it as a minor procedure, while another stated it was seldom used. Haque ME, Marriott L, Naeem N, Henry T, Conde AJ, Kersaudy-Kerhoas M. PLoS One. Our hypothesis was that hemolysis rates of blood specimens differ dependent on the blood collection technique by venipuncture or intravenous catheter draw. the patients vein. https://doi.org/10.1177/0898010116660397. Disclaimer. World Health Organization. but for all types of clinical wastes. *Wipe in circular motion, spiraling from a Physician. This study included participants from two paediatric hospitals in Stockholm, Sweden, caring for a wide range of conditions. To describe nurses experiences of blood sampling procedures with hospitalized children in a paediatric hospital context. Unfortunately, the blood sampling collection procedure is often affected by pre-analytical . The authors would like to express our appreciation to the nurses who agreed to share their experiences with us and made this study possible. Standard operating procedure for disposal of sharp Collection of Diagnostic Venous Blood Specimens. Qualitative Research in Psychology. 2006;3(2):77101. PURPLE, 5 ml draw plan tube with no syringe, insert the needle into BLUE ]. Google Scholar. Nursing responsibilities for Blood specimen Role of laboratory medicine in collaborative healthcare. securely fasten the The nurses could have been helped further if the guidelines had been more specific about when to use which sampling method for age and developmental stages and analyses. [Risk of hemolysis in blood sampling from peripheral intravenous catheter: a literature review]. Clean the venipuncture site with alcohol 2Community Practitioner, Nurse Prescriber, Senior Sister, Huntingdon Mobile Team, NHS Blood and Transplant. sodium citrate anticoagulant for As a phlebotomist, you will take blood samples from patients which are examined in a laboratory and the results can be used to quickly diagnose diseases and conditions. plasma or whole blood samples. Horn K, Pilkington L, Hooten P. Pediatric Staff Nurses Conceptualizations of Professional Development. Record the date and time of blood sample National Library of Medicine anaemia; blood; blood administration; blood components; blood transfusion; clinical; clinical guidelines; evidence-based practice; nursing care; professional. A standardized data collection form was completed. Sodium fluoride anticoagulant for Total samples by nurse were affected by EMS patients arriving with existing intravenous lines, and nurse schedules affected total samples per nurse. CAS Physical assessment Nelson Munthali . NA conducted the first interview. Qual Health Res. Karlsson K, Rydstrom I, Enskar K, Englund AC. References. Are laboratory tests always needed? 2022 Jun;76(3):175-182. doi: 10.5455/medarh.2022.76.175-182. 2014;2014:538704. separation gel and clot activator MeSH A 3 ml draw tube with 30 mg 2014;138(8):10038. drawn and how patient tolerated the Clin Biochem. Lancet Oncol. You have entered an incorrect email address! However, there are medical devices that visualise the veins, which could benefit venous withdrawal of blood in children [39]. anticoagulant for These findings indicate that nurses lack knowledge and deeper understanding of handling specimens and avoiding pre-analytical errors, such as clots and haemolysis. Laboratory would then be notified of the collection site. This finding was significant (x2 < 0.001). performed using the antecubital fossa, vein of the Everyone should get trainedjust like getting CPR once a year, you can have needle training once a year. (Nurses Group 1). The https:// ensures that you are connecting to the To avoid needle prick injuries. J Nanobiotechnology. The four subthemes was: Nurses feelings of frustration with unsuccessful samplings, Nurses believe in team work, Venous blood sampling was experienced as the best option, and Nurses thoughts and needs in regard to developing skills in paediatric blood sampling. The https:// ensures that you are connecting to the (for staff & patient) by strictly Piazza J, Merkel S, Neusius H, Murphy S, Gargaro J, Rothberg B, et al. determined by the tube vacuum, which is usually Therefore, the aim of this study therefore was to describe paediatric nurses experiences of blood sampling collections from children. https://doi.org/10.1111/apa.14528. Monitor patient health and record signs. available blood may be transported in a sterile tube containing a sterile The frequent overdraw is a documented potential risk of hospital-acquired anaemia [ ], which confirms the nurses' concerns and should lead to doctors and health organisations improving care and communication concerning this aspect. Specimen collection Nelson Munthali 99.6K views27 slides. OSHA requires sharp collection container to be In paediatric care the nurses should be responsive and aim to listen to the childs previous experience and to be supportive in the needle-related procedures [41]. Table 1 describes their age and clinical background. Avoid manipulation of needles as much as PubMed This site needs JavaScript to work properly. Clin Biochem. 2019;6(9):7201. Inside Swedish paediatric hospitals, blood sampling is mainly performed by nurses without support from laboratory personnel [9]. Biochem Med (Zagreb). The COREQ guidelines were used as a help for reporting in this study and increased trustworthiness. Personnels Experiences of Phlebotomy Practices after Participating in an Educational Intervention Programme. We created a phlebotomy training program with roleplaying scenarios in which the learners played the role of a nurse and a patient. Preanalytical quality improvement. The nurses felt frustrated, bringing their concerns for the child in focus. All rights reserved - Made with by unibask.com, Nursing Education and Introduction to Research and Statistics, Introduction to Nursing Research and Statistics. We believe we reached information power, as described in Malterud et al., 2016, after the three interviews including 19 participants. Blood culture collections are needed to make sure that patients do not have any foreign organisms in their bloodstream that can prevent them from remaining healthy. The literature states that the most common pre-analytical errors are haemolysed sample, unfilled or inappropriate sample, clotted sample, wrong container, patient identification or transport problems [8]. From the three focus group interviews we analysed patterns and meanings of the following main theme Paediatric blood sampling is a challenge for the nurses and the four subthemes Nurses feelings of frustration with unsuccessful samplings, Nurses believe in team work, Venous blood sampling was experienced as the best option, and Nurses thoughts and needs regarding skills development in paediatric blood sampling. CLSI standard GP41, Wayne, PA: Clinical and Laboratory Standards Institute; 2017. The nurses often had to deal with the anxiety and fears of both the child and their parents. The nurses were eager to learn more and wanted to improve their skills but did not know how and when it could done. Our results also highlighted challenges in coping with parents, children with special needs and the nurses own self-confidence during the procedure. A written consent document was handed out and signed at the time of the interviews. better if theres more of you, not just for distraction but also so you have someone who can hand you things, stand and turn tubes. Save my name, email, and website in this browser for the next time I comment. Advocate for the health and wellbeing of patients. Lippi G, Chance JJ, Church S, Dazzi P, Fontana R, Giavarina D, et al. (Nurses Group 1). The nurses felt that learning by doing and by observing colleagues was the main way nurses embraced knowledge. anticoagulant. The experienced nurses often investigated the childs condition first and could feel when sampling was unnecessary, prompting them to ask the clinicians to rethink the ordering of blood samples in order to reduce the number of punctures. The informants were often experienced in adult care, where they felt self-confident, but this changed when they started working in the paediatric hospital. regarding waste disposal not only for sharps Methods: Eleven experienced registered nurses with more than 2 years' ED experience completed a standardized phlebotomy retraining session. high and test result can be altered. Other times the parents wanted to be optimistic for the child, telling them the blood sampling procedure would go fine with no pain and that it would be just one jab, when the nurses knew this was not true. procedure, and to parents for small babies. Provider Perspectives on Partnering With Parents of Hospitalized Children to Improve Safety. You get very angry and I called the lab and asked why it was like this and then they had no real answer so then you get really angry. (Nurses Group 1). 8600 Rockville Pike J Appl Lab Med. Procedures and Devices for the Collection of Diagnostic Capillary Blood Specimens. Im not asking help for my sake I can push the needle in ten times but its for the childs sake, isnt it so you dont damage the vessels. (Nurses Group 1). Many times the nurses had put all their effort and fighting spirit into the procedure and when the results came back reporting errors, this caused sadness, frustration and anger. thoroughly and don gloves The implications of this study are that paediatric hospital care needs to focus on improving guidelines for and increasing competence in blood sampling children and helping nurses to understand why samplings may be unsuccessful and how this can be avoided.