Henrik Hjelmgren MSN, Anna Nilsson MD, Ida H. Myrberg BSc, Nina Andersson PhD, Britt-Marie Ygge, Björn Nordlund PhD
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The risk of preanalytical errors was analyzed with adjusted-odds ratio (adj-OR) by multivariable logistic regression with 95% confidence intervals (CIs).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Overall, 128 (13%) preanalytical errors were identified among 951 blood samples. The proportion and adj-OR of errors was significantly higher in capillary compared with venous blood samples, 72 (20%) of 354 versus 56 (9.4%) of 597, <i>p</i> = .001, adj-OR 2.88 (CI 1.79–4.64). Blood collection with multiple sample tubes was significantly associated with increased risk of preanalytical errors (<i>n</i> = 97 of 601, 16%), while log weight (kg) significantly decreased the risk of preanalytical errors adj-OR 0.66 (CI 0.50–0.86), indicating a protective effect of increasing weight. However, stratified analyses indicated a protective effect of increasing log weight for venous blood sampling adj-OR 0.52 (CI 0.38–0.72), but not capillary blood sampling, adj-OR 1.08 (CI 0.76–1.55).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>This study indicates that capillary blood sampling collection increases the risk of preanalytical errors. Further, a child's increasing body weight reduced the risk of preanalytical errors, while multiple sample tube collections significantly increased the risk of preanalytical errors.</p>\n </section>\n \n <section>\n \n <h3> Practice Implications</h3>\n \n <p>This new information may help nurses improve their knowledge concerning blood sampling collection in pediatrics. 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引用次数: 6
摘要
目的血液取样程序复杂且容易失败，这反映在儿科医院护理的分析前错误中。本研究的主要目的是评估毛细管采血是否比静脉血采血发生分析前错误的风险更高，其次是探讨与分析前错误相关的具体因素，包括毛细管和静脉血采血的总体和分层。设计与方法本观察性儿科医院研究收集了2014 - 2016年的医疗记录和血液抽样调查结果。分析前误差风险采用校正优势比(adjor)，多变量logistic回归，95%置信区间(ci)。结果951份血样中共发现128例(13%)分析前错误。与静脉血样本相比，毛细血管样本的错误比例和误差比均显著高于静脉血样本，分别为354例中的72例(20%)和597例中的56例(9.4%)，p =。001, ji - or 2.88 (CI 1.79-4.64)。多管采血与分析前错误风险增加显著相关(n = 97 / 601, 16%)，而对数体重(kg)显著降低分析前错误风险(or为0.66)(CI为0.50-0.86)，表明增加体重具有保护作用。然而，分层分析表明，增加静脉血取样的对数重量具有保护作用，比值为0.52 (CI 0.38-0.72)，而毛细血管取样则没有，比值为1.08 (CI 0.76-1.55)。结论本研究表明，毛细管采血增加了分析前错误的风险。此外，儿童体重的增加降低了分析前错误的风险，而多次采集样管显著增加了分析前错误的风险。实践启示这一新信息可能有助于护士提高他们对儿科血液采集的认识。综上所述，本研究还表明，实施更多的静脉血采样和提高毛细管采样的情况可以减少儿科医院分析前错误的数量。
Capillary blood sampling increases the risk of preanalytical errors in pediatric hospital care: Observational clinical study
Purpose
The blood sampling procedure is complex and prone to failure, as reflected by preanalytical errors in pediatric hospital care. The primary aim was to evaluate if the risk of preanalytical errors was higher with capillary blood sampling than with venous blood sampling, and secondary, explore specific factors associated with preanalytical errors, both overall and stratified by capillary and venous blood sampling.
Design and Methods
This observational pediatric hospital study collected outcomes from medical records and blood sampling surveys from year 2014 to 2016. The risk of preanalytical errors was analyzed with adjusted-odds ratio (adj-OR) by multivariable logistic regression with 95% confidence intervals (CIs).
Results
Overall, 128 (13%) preanalytical errors were identified among 951 blood samples. The proportion and adj-OR of errors was significantly higher in capillary compared with venous blood samples, 72 (20%) of 354 versus 56 (9.4%) of 597, p = .001, adj-OR 2.88 (CI 1.79–4.64). Blood collection with multiple sample tubes was significantly associated with increased risk of preanalytical errors (n = 97 of 601, 16%), while log weight (kg) significantly decreased the risk of preanalytical errors adj-OR 0.66 (CI 0.50–0.86), indicating a protective effect of increasing weight. However, stratified analyses indicated a protective effect of increasing log weight for venous blood sampling adj-OR 0.52 (CI 0.38–0.72), but not capillary blood sampling, adj-OR 1.08 (CI 0.76–1.55).
Conclusion
This study indicates that capillary blood sampling collection increases the risk of preanalytical errors. Further, a child's increasing body weight reduced the risk of preanalytical errors, while multiple sample tube collections significantly increased the risk of preanalytical errors.
Practice Implications
This new information may help nurses improve their knowledge concerning blood sampling collection in pediatrics. Altogether, this study also indicates that implementing more venous blood sampling and improve the cases of capillary sampling could reduce the number of preanalytical errors in pediatric hospitals.
期刊介绍：
Linking science and practice by publishing evidence-based information on pediatric nursing and answering the question, ''How might this information affect nursing practice?''
The Journal for Specialists in Pediatric Nursing (JSPN) is the international evidence-based practice journal for nurses who specialize in the care of children and families. JSPN bridges the gap between research and practice by publishing peer-reviewed reliable, clinically relevant, and readily applicable evidence. The journal integrates the best evidence with pediatric nurses'' passion for achieving the best outcomes. The journal values interdisciplinary perspectives and publishes a wide variety of peer-reviewed papers on clinically relevant topics.
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