'True Blood' The Critical Care Story: an audit of blood sampling practice across adult, paediatric and neonatal intensive care settings

Ullman, Amanda, Keogh, Samantha, Coyer, Fiona, Long, Deborah A., New, Karen and Richard, Claire M. (2015) 'True Blood' The Critical Care Story: an audit of blood sampling practice across adult, paediatric and neonatal intensive care settings. Australian Critical Care, 29 2: 90-95. doi:10.1016/j.aucc.2015.06.002


Author Ullman, Amanda
Keogh, Samantha
Coyer, Fiona
Long, Deborah A.
New, Karen
Richard, Claire M.
Title 'True Blood' The Critical Care Story: an audit of blood sampling practice across adult, paediatric and neonatal intensive care settings
Journal name Australian Critical Care   Check publisher's open access policy
ISSN 1036-7314
1878-1721
Publication date 2015-01-01
Year available 2015
Sub-type Article (original research)
DOI 10.1016/j.aucc.2015.06.002
Open Access Status DOI
Volume 29
Issue 2
Start page 90
End page 95
Total pages 6
Place of publication Philadelphia, PA United States
Publisher Elsevier
Language eng
Abstract Anaemia is common in critically ill patients, and has a significant negative impact on patients' recovery. Blood conservation strategies have been developed to reduce the incidence of iatrogenic anaemic caused by sampling for diagnostic testing.

Describe practice and local guidelines in adult, paediatric and neonatal Australian intensive care units (ICUs) regarding blood sampling and conservation strategies.

Cross-sectional descriptive study, conducted July 2013 over one week in single adult, paediatric and neonatal ICUs in Brisbane. Data were collected on diagnostic blood samples obtained during the study period, including demographic and acuity data of patients. Institutional blood conservation practice and guidelines were compared against seven evidence-based recommendations.

A total of 940 blood sampling episodes from 96 patients were examined across three sites. Arterial blood gas was the predominant reason for blood sampling in each unit, accounting for 82% of adult, 80% of paediatric and 47% of neonatal samples taken (p<0.001). Adult patients had significantly more median [IQR] samples per day in comparison to paediatrics and neonates (adults 5.0 [2.4]; paediatrics 2.3 [2.9]; neonatal 0.7 [2.7]), which significantly increased median [IQR] blood sampling costs per day (adults AUD$101.11 [54.71]; paediatrics AUD$41.55 [56.74]; neonatal AUD$8.13 [14.95]; p<0.001). The total volume of samples per day (median [IQR]) was also highest in adults (adults 22.3mL [16.8]; paediatrics 5.0mL [1.0]; neonates 0.16mL [0.4]). There was little information about blood conservation strategies in the local clinical practice guidelines, with the adult and neonatal sites including none of the seven recommendations.

There was significant variation in blood sampling practice and conservation strategies between critical care settings. This has implications not only for anaemia but also infection control and healthcare costs.
Formatted abstract
Background

Anaemia is common in critically ill patients, and has a significant negative impact on patients’ recovery. Blood conservation strategies have been developed to reduce the incidence of iatrogenic anaemic caused by sampling for diagnostic testing.

Objectives

Describe practice and local guidelines in adult, paediatric and neonatal Australian intensive care units (ICUs) regarding blood sampling and conservation strategies.

Methods

Cross-sectional descriptive study, conducted July 2013 over one week in single adult, paediatric and neonatal ICUs in Brisbane. Data were collected on diagnostic blood samples obtained during the study period, including demographic and acuity data of patients. Institutional blood conservation practice and guidelines were compared against seven evidence-based recommendations.

Results

A total of 940 blood sampling episodes from 96 patients were examined across three sites. Arterial blood gas was the predominant reason for blood sampling in each unit, accounting for 82% of adult, 80% of paediatric and 47% of neonatal samples taken (p < 0.001). Adult patients had significantly more median [IQR] samples per day in comparison to paediatrics and neonates (adults 5.0 [2.4]; paediatrics 2.3 [2.9]; neonatal 0.7 [2.7]), which significantly increased median [IQR] blood sampling costs per day (adults AUD$101.11 [54.71]; paediatrics AUD$41.55 [56.74]; neonatal AUD$8.13 [14.95]; p < 0.001). The total volume of samples per day (median [IQR]) was also highest in adults (adults 22.3 mL [16.8]; paediatrics 5.0 mL [1.0]; neonates 0.16 mL [0.4]). There was little information about blood conservation strategies in the local clinical practice guidelines, with the adult and neonatal sites including none of the seven recommendations.

Conclusions

There was significant variation in blood sampling practice and conservation strategies between critical care settings. This has implications not only for anaemia but also infection control and healthcare costs.
Keyword Blood conservation strategies
Blood specimen collection
Critical care
Evidence based nursing
Nursing research
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Nursing, Midwifery and Social Work Publications
 
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Created: Thu, 09 Jul 2015, 22:58:16 EST by Ms Karen New on behalf of School of Nursing, Midwifery and Social Work