A Potassium-Based Quality-of-Service Metric Reduces Phlebotomy Errors, Resulting in Improved Patient Safety and Decreased Cost.
Am J Clin Pathol
; 157(5): 789-798, 2022 05 04.
Article
in English
| MEDLINE | ID: covidwho-2114767
ABSTRACT
OBJECTIVES:
Poor phlebotomy technique can introduce pseudohyperkalemia without hemolysis, requiring additional workup and placing a significant burden on patients, clinical teams, and laboratories. Such preanalytical biases can be detected through systematic evaluation of potassium concentrations on a per-phlebotomist basis. We report our long-term experience with a potassium-based quality-of-service phlebotomy metric and its effects on resource utilization.METHODS:
Potassium monitoring and retraining of 26 full-time phlebotomists were piloted as a quality-of-service intervention. Changes in potassium concentrations and impact on resource utilization were assessed. An algorithm for data monitoring and phlebotomist feedback was developed, followed by institution-wide implementation.RESULTS:
Systematic intervention and retraining normalized K+ concentrations and lowered the percentage of venipunctures with K+ above 5.2 mmol/L, leading to a marked increase in phlebotomist compliance. This change resulted in resources savings of 13% to 100% for individual phlebotomists, reducing the total extra laboratory time required for repeat phlebotomies to determine hyperkalemia, mostly in the high-volume phlebotomist group.CONCLUSIONS:
A quality-of-service algorithm that involved monitoring potassium concentrations on a per-phlebotomist basis with feedback and retraining contributed to a concrete, data-based quality improvement plan. The institution-wide implementation of this metric allowed for significant cost savings and a reduction in critical value alerts, directly affecting the quality of patient care.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Potassium
/
Phlebotomy
Type of study:
Experimental Studies
/
Prognostic study
/
Systematic review/Meta Analysis
Limits:
Humans
Language:
English
Journal:
Am J Clin Pathol
Year:
2022
Document Type:
Article
Affiliation country:
Ajcp
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