Drawing blood from peripheral intravenous cannula compared with venepuncture: A systematic review and meta-analysis.

AIMS: To synthesize the evidence evaluating if blood samples are similar when obtained from peripheral intravenous cannula compared with venepuncture. DESIGN: A systematic review and meta-analysis was undertaken. DATA SOURCES: Searches were conducted in databases for English language studies between January 2000-December 2018. REVIEW METHODS: The search adhered to the Meta-analysis of Observational Studies in Epidemiology guidelines. The methodological quality of studies was assessed using Joanna Briggs critical appraisal instruments. The overall quality of the evidence was assessed using the GRADE. RESULTS: Sixteen studies were identified. Findings suggest haemolysis rates are higher in blood sampled from peripheral intravenous cannula. However, haemolysis rates may be lower if a peripheral intravenous cannula blood sampling protocol is followed. For equivalence of blood test results, even though some results were outside the laboratory, allowable error and were outside the Bland-Altman Level of Agreement, none of these values would have required clinical intervention. With regard to the contamination rates of blood cultures, the results were equivocal. CONCLUSION: Further research is required to inform the evidence for best practice recommendations, including, if a protocol for drawing blood from a peripheral cannula is of benefit for specific patient populations and in other settings. IMPACT: Venepuncture can provoke pain, anxiety and cause trauma to patients. Guidelines recommend blood samples from peripheral intravenous cannula be taken only on insertion. Anecdotal evidence suggests drawing blood from existing cannulas may be a common practice. Further research is required to resolve this issue.

Validation of data using RASCH analysis in a tool measuring changes in critical thinking in nursing students.

BACKGROUND: In Australia there is no national examination to assess student competency with respect to critical thinking skills on graduation from undergraduate registered nurse program. OBJECTIVES: To describe the use of Rasch analysis for the validation of a tool that measures critical thinking in nursing students in Australia. DESIGN: A cross sectional survey was used to assess students' critical thinking. SETTINGS: One Australian university. PARTICIPANTS: Seventy-four first year and third year nursing students participated in the project. METHODS: Nursing students at one university were requested to undertake a multiple choice question survey to determine their level of critical thinking. The survey tool was validated using Rasch analysis software. RESULTS: Rasch analysis enabled identification of the difficulty of each question, enabling the assessment to identify difference between students and for each student cohort. The use of Rasch analysis demonstrated marked differences in the students' critical thinking abilities, showing higher levels of critical thinking for third year students with greater ability to answer the more difficult questions. CONCLUSION: Rasch analysis enables the matching of test questions to the cognitive skill level of students, and is a useful tool for validating multiple choice questionnaires. Use of this method of analysis can provide a robust assessment in which questions are matched to the level of the learner and enable differentiation between high and low achieving students.