Article Text

  1. K Tanney1,
  2. J W Davis1,
  3. E McCall2,
  4. S Murray3,
  5. J S Craig2,
  6. C Mayes1
  1. 1Department of Neonatology, Royal Jubilee Maternity Service, Belfast, N. Ireland, UK,
  2. 2NICORE, Institute of Child Health, Queen’s University of Belfast, Belfast, N. Ireland, UK,
  3. 3Northern Ireland Blood Transfusion Service, Belfast City Hospital, Belfast, N. Ireland, UK


Background and aims Blood sample volume in excess of laboratory requirements is a key factor leading to increased transfusion requirements. In the regional NICU in Northern Ireland phlebotomy is undertaken by junior medical staff, with no targeted education. Junior doctors establish the required blood volumes by cumulative experience. We aimed to describe the pattern of neonatal phlebotomy over two time periods and to determine the necessity of formal phlebotomy education.

Methods Early morning blood sampling was assessed before and after an educational package, which detailed regional laboratory volume requirements. We recorded sample source, infant weight, gestation and day of life. Samples were weighed at laboratory level and classified as sufficient, insufficient, clotted or overdrawn. The volume was calculated using the specific gravity of blood and converted to percentage of laboratory-requested volume. The phlebotomists were blinded to this review process.

Results See table.


Tanney et al

We can conclude that staff are achieving high standards in sample collection and utilisation, with only 1–2% of samples being insufficient. The infants in the group assessed following educational intervention were heavier, which may effect the degree of reduction in overdraw. We are currently modifying the educational package and aim to continue to review our phlebotomy practice. We suggest that learning by cumulative experience is sufficient to maintain high standards in neonatal phlebotomy practice.

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