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Stonys R, Vitkus D. Assessing Non-Laboratory Healthcare Professionals' Attitude towards the Importance of Patient Preparation for Laboratory Tests. Healthcare (Basel) 2024; 12:989. [PMID: 38786400 PMCID: PMC11120851 DOI: 10.3390/healthcare12100989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/21/2024] [Accepted: 05/08/2024] [Indexed: 05/25/2024] Open
Abstract
(1) Background: Various guidelines address patient preparation and its importance for venous blood sampling, such as the GP41 guideline issued by the Clinical Laboratory Standards Institute (CLSI) and the blood collection guidelines published by the World Health Organisation. Recommendations provided by national societies or international organisations in the field of radiology, such as The Contrast Media Safety Committee of the European Society of Urogenital Radiology, or in the field of laboratory medicine, such as the Working Group for Preanalytical Phase (WG-PRE) of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and the Latin American Working Group for Preanalytical Phase (WG-PRE-LATAM) of the Latin American Confederation of Clinical Biochemistry (COLABIOCLI), also guide this practice. There is a notable lack of understanding regarding the viewpoints held by non-laboratory healthcare professionals concerning the significance of patient preparation for laboratory testing and the impact of typical factors associated with patient preparation. This study endeavours to bridge this gap by assessing the attitude of non-laboratory healthcare professionals in Lithuania regarding these pivotal aspects. (2) Methods: A self-designed anonymous questionnaire was disseminated among 141 public healthcare institutions in Lithuania. The internal consistency of the questionnaire was evaluated by computing Cronbach's alpha. Descriptive statistics were utilised for the variables, while comparisons of attitude among groups were conducted using Mann-Whitney U (for two groups) or Kruskal-Wallis (for more than two groups) for categorical and discrete indicators. The Kruskal-Wallis post-hoc test was employed for pairwise comparisons. A significance level of p-Value < 0.05 was applied to establish statistical significance. (3) Results: A total of 158 respondents constituted two distinct groups of healthcare professionals: nurses and physicians. Most of the participants either agreed or strongly agreed that patient preparation could introduce bias into laboratory test results. Professionals with less than 20 years of work experience or those who attended training in patient preparation for sampling within a 5-year timeframe exhibited stronger agreement regarding different preanalytical factors in patient preparation and their impact on laboratory test results compared to their counterparts. (4) Conclusions: Non-laboratory healthcare professionals who participated in this survey consider proper patient preparation for laboratory testing to be a significant step towards obtaining accurate test results. They also recognize the commonly acknowledged preanalytical factors as important for ensuring reliable test results. However, attitudes towards the importance of several preanalytical factors vary depending on whether non-laboratory healthcare professionals have more or less than 20 years of work experience, as well as whether they have attended any training on this topic within the last five years or have never attended such training.
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Affiliation(s)
- Ričardas Stonys
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, M.K. Ciurlionio str. 21, LT-03101 Vilnius, Lithuania;
- Centre of Laboratory Medicine, Vilnius University Hospital Santaros Klinikos, Santariskiu str. 2, LT-08406 Vilnius, Lithuania
| | - Dalius Vitkus
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, M.K. Ciurlionio str. 21, LT-03101 Vilnius, Lithuania;
- Centre of Laboratory Medicine, Vilnius University Hospital Santaros Klinikos, Santariskiu str. 2, LT-08406 Vilnius, Lithuania
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Benozzi SF, Unger G, Campion A, Milano PG, Pennacchiotti GL. Coffee intake one hour prior to phlebotomy produces no clinically significant changes in routine biochemical test results. Biochem Med (Zagreb) 2023; 33:020705. [PMID: 37324115 PMCID: PMC10231766 DOI: 10.11613/bm.2023.020705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 04/25/2023] [Indexed: 06/17/2023] Open
Abstract
Introduction Although current guidelines recommend not drinking coffee prior to phlebotomy, our hypothesis is that drinking coffee does not affect the clinical interpretation of biochemical and haematological test results. Materials and methods Twenty-seven volunteers were studied in basal state (T0) and 1h after (T1) drinking coffee. Routine haematological (Sysmex-XN1000 analyser) and biochemistry parameters (Vitros 4600 analyser) were studied. Results were compared using the Wilcoxon test (P < 0.05). A clinical change was considered when mean percent difference (MD%) was higher than the reference change value (RCV). Results Coffee intake produced statistically, but not clinically, significant: i) increases in haemoglobin (P = 0.009), mean cell haemoglobin concentration (P = 0.044), neutrophils (P = 0.001), albumin (P = 0.001), total protein (P = 0.000), cholesterol (P = 0.025), high density lipoprotein cholesterol (P = 0.007), uric acid (P = 0.011), calcium (P = 0.001), potassium (P = 0.010), aspartate aminotransferase (P = 0.001), amylase (P = 0.026), and lactate dehydrogenase (P = 0.001), and ii) decreases in mean cell volume (P = 0.002), red cell distribution width (P = 0.001), eosinophils (P = 0.002), and lymphocytes (P = 0.001), creatinine (P = 0.001), total bilirubin (P = 0.012), phosphorus (P = 0.001), magnesium (P = 0.007), and chloride (P = 0.001). Conclusion Drinking a cup of coffee 1 hour prior to phlebotomy produces no clinically significant changes in routine biochemical and haematological test results.
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Affiliation(s)
- Silvia F Benozzi
- Departamento de Biología, Bioquímica y Farmacia, Universidad Nacional del Sur (UNS), Bahía Blanca, Argentina
| | - Gisela Unger
- Departamento de Biología, Bioquímica y Farmacia, Universidad Nacional del Sur (UNS), Bahía Blanca, Argentina
| | - Amparo Campion
- Departamento de Biología, Bioquímica y Farmacia, Universidad Nacional del Sur (UNS), Bahía Blanca, Argentina
- Hospital Municipal de Agudos "Dr. Leónidas Lucero", Bahía Blanca, Argentina
| | - Pablo G Milano
- Departamento de Biología, Bioquímica y Farmacia, Universidad Nacional del Sur (UNS), Bahía Blanca, Argentina
- Instituto de Investigaciones Bioquímicas de Bahía Blanca (INIBIBB), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Nacional del Sur (UNS), Bahía Blanca, Argentina
| | - Graciela L Pennacchiotti
- Departamento de Biología, Bioquímica y Farmacia, Universidad Nacional del Sur (UNS), Bahía Blanca, Argentina
- Hospital Municipal de Agudos "Dr. Leónidas Lucero", Bahía Blanca, Argentina
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Hepburn S, Jankute M, Cornes MP, Rios NR, Stretton A, Costelloe SJ. Survey of patient perception of pre-analytical requirements for blood testing in the UK and RoI. Ann Clin Biochem 2020; 58:132-140. [PMID: 33275445 DOI: 10.1177/0004563220982325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND A patient survey developed by the Pre-Analytical Phase Special Interest Group of the Association for Clinical Biochemistry and Laboratory Medicine (ACB-PA-SIG) was conducted during November and December 2019. The survey aimed to determine the quality of information provided to patients in preparation for their blood test(s). In addition, the ACB-PA-SIG provide a number of recommendations, which, if adopted, may yield higher quality test results and improve patient management. METHODS The survey was distributed at phlebotomy suites in two Hospitals: Ipswich Hospital (United Kingdom [UK]), and Cork University Hospital (Republic of Ireland [RoI]). RESULTS Overall, 235 survey responses were received from the two sites. A total of 103 respondents received no information about preparing for their blood test and 92 had been told they did not need to fast. None of the patients surveyed had been instructed to fast for 12 h. Twenty-two patients had been told to avoid certain foods, drinks or medication, 14 were told to avoid strenuous activity and 41 respondents had been informed of the need to avoid alcohol/smoking prior to their blood test. Overall, only approximately 78 felt well informed about the blood taking process. CONCLUSIONS Based on the results of this survey, the ACB-PA-SIG conclude that: (1) clinicians should provide clear written information to patients regarding pre-analytical requirements; and (2) effective communication between laboratories and General Practitioners is required to disseminate information. In this paper, the ACB-PA-SIG provide a list of pre-analytical recommendations to standardize and improve practice across the UK and RoI.
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Affiliation(s)
- S Hepburn
- Department of Clinical Biochemistry, Ipswich Hospital, East Suffolk and North Essex NHS Foundation Trust, Ipswich, UK
- Association of Clinical Biochemistry and Laboratory Medicine Pre-Analytical Phase Special Interest Group, London, UK
| | - M Jankute
- Association of Clinical Biochemistry and Laboratory Medicine Pre-Analytical Phase Special Interest Group, London, UK
- Department of Clinical Chemistry, Birmingham Children's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - M P Cornes
- Association of Clinical Biochemistry and Laboratory Medicine Pre-Analytical Phase Special Interest Group, London, UK
- Department of Clinical Chemistry, Worcestershire Acute Hospital NHS Trust, Worcester, UK
| | - N Rico Rios
- Department of Clinical Biochemistry, Cork University Hospital, Wilton, Cork, Republic of Ireland
| | - A Stretton
- Association of Clinical Biochemistry and Laboratory Medicine Pre-Analytical Phase Special Interest Group, London, UK
- Becton, Dickinson U.K. Ltd, Wokingham, UK
| | - S J Costelloe
- Association of Clinical Biochemistry and Laboratory Medicine Pre-Analytical Phase Special Interest Group, London, UK
- Department of Clinical Biochemistry, Cork University Hospital, Wilton, Cork, Republic of Ireland
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Arredondo ME, Aranda E, Astorga R, Brennan-Bourdon LM, Campelo MD, Flores S, Medel C, Manríquez I, Ochoa P, Varela B, Salinas CV, Lima-Oliveira G. Breakfast can Affect Routine Hematology and Coagulation Laboratory Testing: An Evaluation on Behalf of COLABIOCLI WG-PRE-LATAM. TH OPEN 2019; 3:e367-e376. [PMID: 31853513 PMCID: PMC6917510 DOI: 10.1055/s-0039-3401002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 10/25/2019] [Indexed: 10/26/2022] Open
Abstract
Laboratories worldwide perform both hematological and coagulation testing on patients avoiding fasting time. In 2017, the Latin America Confederation of Clinical Biochemistry (COLABIOCLI) commissioned the Latin American Working Group for Preanalytical Phase (WG-PRE-LATAM) to study preanalytical variability and establish guidelines for preanalytical procedures to be applied by clinical laboratories and health care professionals. This study, on behalf of COLABIOCLI WG-PRE-LATAM, aims to evaluate the effect of the breakfast on routine hematology and coagulation laboratory testing. We studied 20 healthy volunteers who consumed a breakfast containing a standardized amount of carbohydrates, proteins, and lipids. We collected blood specimens for routine hematology and coagulation laboratory testing before breakfast and 1, 2, and 4 hours thereafter. Significant differences between samples were assessed by the Wilcoxon ranked-pairs test. Statistically significant differences ( p < 0.05) between basal and 4 hours after the breakfast were observed for red blood cells, hemoglobin, hematocrit, mean corpuscular volume, white blood cells, neutrophils, lymphocytes, monocytes, mean platelet volume, and activated partial thromboplastin time. In conclusion, the significant variations observed in several hematological parameters, and activated partial thromboplastin time due to breakfast feeding demonstrate that the fasting time needs to be carefully considered prior to performing routine hematological and coagulation testing to avoid interpretive mistakes of test results, and to guarantee patient safety. Therefore, COLABIOCLI WG-PRE-LATAM encourages laboratory quality managers to standardize the fasting requirements in their laboratory, i.e., 12 hours.
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Affiliation(s)
| | - Eduardo Aranda
- Laboratory of Thrombosis and Hemostasis, Department of Hematology-Oncology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Lorena Michele Brennan-Bourdon
- Clinical Laboratory Network from the State of Jalisco, Public Health State Laboratory (LESP), Comisión Para la Protección Contra Riesgos Sanitarios del Estado de Jalisco (COPRISJAL), Guadalajara, Mexico
| | | | | | | | | | - Patricia Ochoa
- Facultad de Medicina, Universidad Católica de Cuenca, Cuenca, Ecuador
| | | | | | - Gabriel Lima-Oliveira
- Section of Clinical Biochemistry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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Alnor AB, Vinholt PJ. Paediatric reference intervals are heterogeneous and differ considerably in the classification of healthy paediatric blood samples. Eur J Pediatr 2019; 178:963-971. [PMID: 30997593 DOI: 10.1007/s00431-019-03377-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 03/25/2019] [Accepted: 03/26/2019] [Indexed: 11/30/2022]
Abstract
The aim was to elude differences in published paediatric reference intervals (RIs) and the implementations hereof in terms of classification of samples. Predicaments associated with transferring RIs published elsewhere are addressed. A local paediatric (aged 0 days to < 18 years) population of platelet count, haemoglobin level and white blood cell count, based on first draw samples from general practitioners was established. PubMed was used to identify studies with transferable RIs. The classification of local samples by the individual RIs was evaluated. Transference was done in accordance with the Clinical and Laboratory Standards Institute EP28-A3C guideline. Validation of transference was done using a quality demand based on biological variance. Twelve studies with a combined 28 RIs were transferred onto the local population, which was derived from 20,597 children. Studies varied considerably in methodology and results. In terms of classification, up to 63% of the samples would change classification from normal to diseased, depending on which RI was applied. When validating the transferred RIs, one RI was implementable in the local population. Conclusion: Published paediatric RIs are heterogeneous, making assessment of transferability problematic and resulting in marked differences in classification of paediatric samples, thereby potentially affecting diagnosis and treatment of children. What is Known: • Reference intervals (RIs) are fundamental for the interpretation of paediatric samples and thus correct diagnosis and treatment of the individual child. • Guidelines for the establishment of adult RIs exist, but there are no specific recommendations for establishing paediatric RIs, which is problematic, and laboratories often implement RIs published elsewhere as a consequence. What is New: • Paediatric RIs published in peer-reviewed scientific journals differ considerably in methodology applied for the establishment of the RI. • The RIs show marked divergence in the classification of local samples from healthy children.
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Affiliation(s)
- Anne Bryde Alnor
- Department of Clinical Biochemistry and Immunology, Lillebaelt Hospital, Sygehusvej 24, 6000, Kolding, Denmark.
| | - Pernille Just Vinholt
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, 5000, Odense, Denmark
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