Improving the quality of venous blood sampling procedure (phlebotomy): avoiding tourniquet use

Abstract

Background: Guidelines for venous blood sampling procedure (phlebotomy) discourage tourniquet use whenever possible. Here, we aim to assess Biomedical Scientists capability of not using the tourniquet in phlebotomy, which we hypothesised to be equal to 50% of the patients attended, and identifying the most frequent venipuncture site. Materials and Methods: We selected and assigned two (BMS) with the same age (41 years) and experience (20 years) to record ten phlebotomy days, the first with prioritized and the latter with non-prioritized patients. In a simple record form, each acquired daily data for the number of attended patients, age and gender, the frequency of non-tourniquet usage and the punctured vein. To test our work hypothesis we used the two-tailed single sample t-test (p < 0.05). Differences between age-group means and non-tourniquet use means by each BMS were tested by two-tailed t-test for independent means (p < 0.05). Results: In 10 phlebotomy days 683 patients were attended, with males representing 43,2% of the population. We found no statistically difference between age-group means. The combined capability of non-tourniquet use was 50,5%, which did not differ from our null hypothesis, but the individual group-means were statistically different, being 33% and 66.9% in the prioritized vs non-prioritized group. The medial cubital vein was the most prone to be punctured (77,7%). Conclusions: We have shown that performing phlebotomies without tourniquet use is possible and desirable in at least half of the attended patients, though being more limited in specific group populations. Our results provide room for quality improvement in the laboratory pre-analytical phase.