A multicentre observational study evaluating the effectiveness of a phlebotomy check-list in reducing preanalytical errors

Several preanalytical errors are attributable to inappropriate or poorly standardized activities during the venous blood collection. We designed a multicenter observational study to establish whether the implementation of a phlebotomy check-list in 7 phlebotomy centers and 4 emergency departments is effective in reducing the rate of preanalytical errors related to the blood drawing. The investigation was divided in two 3-month periods during which 5 common preanalytical errors were systematically recorded. After the introduction of the phlebotomy check-list, the rate of preanalytical errors was significantly decreased in phlebotomy centers (0.04% vs. 0.05%, P=0.001), but remained unchanged in emergency departments (0.83% vs. 0.82%, P=0.84). A significant decrease was achieved for sample identification errors and clotted specimens in phlebotomy centers and emergency departments, whereas a significant reduction in hemolysis was noticed only in phlebotomy centers. The rate of inappropriate filling and wrong containers remained unchanged. The results obtained in this study show that the introduction of a phlebotomy check-list may help in reducing preanalytical errors related to misidentification and undue clotting.