Impact of Laboratory Diagnostic Preanalytics on Patient Blood Management

This study was designed to investigate the possibility of reducing diagnostic blood loss as a lab-side element of Patient Blood Management. To this end, the nominal blood volume of blood collection tubes was reduced and, additionally, preanalytical processes were optimised to minimise repeated blood collections. These interventions were conducted in conjunction with a change of blood collection system. Auditing the preanalytical phase and observing sample quality before and after the interventions enabled the assessment of changes in preanalytical quality. The occurrence of several blood collection non-compliances had decreased substantially one year after preanalytical training and conversion to the different blood collection system. Improvement of preanalytical quality combined with reduction of tube blood volumes led to a significant decrease in the volume of blood drawn for diagnostic purposes, corresponding to a reduction of 177 L per year for the whole hospital. We also observed a reduction in the total number of blood collection tubes used. An analysis of data for geriatric and Intensive Care Unit (ICU) ward types, where there is a known risk of iatrogenic anaemia, revealed significant blood savings. In conclusion, targeted preanalytical training measures and introduction of blood collection tubes with lower draw volumes enable significant reductions in the volume of patient blood drawn for laboratory diagnostics, and so represent an important contributor to patient blood management