Home >> ALL ISSUES >> 2016 Issues >> Clinical Pathology Abstracts, 11/16

Clinical Pathology Abstracts, 11/16

image_pdfCreate PDF

Editor: Deborah Sesok-Pizzini, MD, MBA, professor, Department of Clinical Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, and chief, Division of Transfusion Medicine, Children’s Hospital of Philadelphia.

Neonatal ICU quality initiative: identifying preanalytical variables that contribute to specimen hemolysis

Hemolysis is a major cause of sample rejection and the need to recollect a specimen from a patient. In the neonatal intensive care unit, this may be of particular concern because of limited venous access and the risk of causing iatrogenic anemia. The authors conducted a quality improvement study with the intent of reducing the rate of specimen rejection due to hemolysis to less than four percent over nine months. They investigated whether intravenous infusion of lipid emulsion during sample collection, as well as sample collection site and blood sample transportation methods, contributed to the hemolysis observed. The investigators used the DMAIC (define, measure, analyze, improve, and control) approach to identify two practice improvements: pausing lipid emulsion infusion prior to sample collection and slowing withdrawal rates through arterial catheters. The results showed that samples were more likely to be hemolyzed if they were collected during lipid infusion and transported by a pneumatic tube or collected through an arterial catheter. A retrospective analysis showed a decreased number of tests cancelled due to specimen hemolysis (from 6.4 to 3.5 percent) after the authors’ interventions. The authors noted that these results may be generalizable to other neonatal intensive care units and could be applied to other aspects of laboratory medicine and clinical care.

Tolan NV, Kaleta EJ, Fang JL, et al. Neonatal intensive care unit quality initiative: identifying preanalytical variables contributing to specimen hemolysis and measuring the impact of evidence-based practice interventions. Am J Clin Pathol. 2016;146:113–118.

Correspondence: Dr. Nikola A. Baumann at baumann.nikola@mayo.edu

CAP TODAY
X