Assessment Of Preanalytical Blood Sampling Errors In Clinical Settings.

BACKGROUND: Blood sampling is one of the common procedures done in every ward for disease diagnosis and prognosis. Daily hundreds of samples are collected from different wards but lack of appropriate knowledge of blood sampling by paramedical staff and accidental errors make the samples inappropriate for testing. Thus the need to avoid these errors for better results still remains. We carried out this research with an aim to determine the common errors during blood sampling; find factors responsible and propose ways to reduce these errors. METHODS: A cross sectional descriptive study was carried out at the Military and Combined Military Hospital Rawalpindi during February and March 2014. A Venous Blood Sampling questionnaire (VBSQ) was filled by the staff on voluntary basis in front of the researchers. The staff was briefed on the purpose of the survey before filling the questionnaire. Sample size was 228. Results were analysed using SPSS-21. RESULTS: When asked in the questionnaire, around 61.6% of the paramedical staff stated that they cleaned the vein by moving the alcohol swab from inward to outwards while 20.8% of the staff reported that they felt the vein after disinfection. On contrary to WHO guidelines, 89.6% identified that they had a habit of placing blood in the test tube by holding it in the other hand, which should actually be done after inserting it into the stand. Although 86% thought that they had ample knowledge regarding the blood sampling process but they didn't practice it properly. CONCLUSIONS: Pre analytical blood sampling errors are common in our setup. Eighty six percent participants though thought that they had adequate knowledge regarding blood sampling, but most of them were not adhering to standard protocols. There is a need of continued education and refresher courses.

RETAINED GAUZE PIECE RESULTING IN RIGHT RENAL COMPLEX CYST DIAGNOSED AFTER 4 YEARS OF PYELOLITHOTOMY.

Renal cysts are the most common space occupying lesions of kidneys. These may be simple or complex. Complex renal cysts are suspicious for malignancy. Computed tomography is the gold standard in diagnosis of complex renal cysts. Negligence resulting in retained surgical foreign bodies does occur in our setup and world over. We present a unique case of retained gauze piece presenting as complex renal cyst, diagnosed four years after pyelolithotomy. A 50 year old male presented with history of on and off right lumbar pain for the last one year, along with low grade intermittent fever and weight loss. Past history revealed that he was operated for renal stones four years ago. Radio imaging including ultrasonography and CT scan revealed complex renal cyst. Patient was explored and found to have thick walled cyst with old gauze in it.