Patient Blood Management: Mixing Versus Discard Methods for Central Venous Catheter Blood Specimen Collection.

Autor:	Sarver MJ; Author Affiliations: Oncology and Infusion Services, Providence Regional Medical Center Everett Cancer Partnership, Everett, Washington (Sarver); Sarver Better Living Products LLC, Everett, Washington (Sarver); Outpatient Infusion Center, University of Washington Medical Center, Seattle, Washington (McManus); Nursing Services, Medical Oncology, Providence Regional Medical Center Everett, Everett, Washington (Toler); Everett Community College, Everett, Washington (Toler); Providence Regional Medical Center Everett, Everett, Washington (Johnson).; Mary Jo Sarver, MN, ARNP, AOCN, CRNI, VA-BC, LNC, is a nurse practitioner at Oncology and Infusion Services, Providence Regional Medical Center Everett Cancer Partnership, Everett, Washington. Ms Sarver has more than 37 years of experience in infusion therapy and oncology/hematology care. Her role focuses on continuity of care and seamless transitions for patients within and outside the acute care setting. She collaborates and acts as a consultant locally and on a system level for Providence, guiding staff development, competency assessment, and process improvement to improve outcomes in multiple areas of clinical practice, and new graduate transition to practice. She attends cancer care conferences, rounds in the clinics and hospital, and actively consults and sees patients and families for treatment and care planning. She has published, conducted research, and spoken on multiple topics within the United States. For decades, passion has prompted her to participate both locally on the PSINS, PSONS, and ACS boards and nationally assume various roles through INS and ONS. She is CEO of Sarver Better Living, a family-run company. Monica McManus, MHA, BSN, RN, OCN, is the assistant nurse manager for an Outpatient Infusion Center at the University of Washington Medical Center. Ms McManus has been working in the nursing profession since 2009. She has expertise in oncology and intensive care nursing. She has functioned in several nursing leadership roles, as assistant nurse manager for inpatient oncology, manager for inpatient Oncology and Surgical Services, and in her current role as assistant nurse manager in Outpatient Infusion. She has published on topics to help improve oncology nursing documentation and on central venous access devices. She has an interest in nursing leadership and in helping to enhance the nursing profession through continued research on quality improvement for oncology and infusion nursing. John Toler, MSN, RN, is an administrative supervisor of Nursing Services; a registered nurse in Medical Oncology at Providence Regional Medical Center Everett; and an associate faculty of Nursing Services at Everett Community College. Mr Toler has 15 years of experience in oncology/hematology care, 3 years in administrative nursing supervision, 3 years in clinical instruction in nursing education, and prior management experience, including the director of nursing services. He is the recipient of several nursing awards, including Nurse of the Year for Innovation within the Providence/Swedish community, and the Faculty Daisy Award in Nursing Education in 2022. His roles transcend several areas of nursing, including leadership, education, mentorship, innovation, research, community relations and development, and direct patient care in the acute care setting. His passion for research and innovation has led to various improvements in operational efficiency, policy revisions, educational system developments, and positive patient outcomes. He continues to volunteer time to the nursing community through educational lectures and clinical precepting for graduates pursuing bachelor's and master's degrees. Bethany Johnson, BSN, RN, OCN, is a nurse educator at Providence Regional Medical Center Everett, (PRMCE) in Everett, Washington. Ms Johnson has worked for more than 15 years as a nurse in Medical Oncology at Providence Regional Medical Center Everett. This year, she transitioned into the role of nurse educator. She works on a system level, developing and teaching new hire education, and on a hospital level as a hands-on resource. As a nurse leader, she has served on and chaired several committees within the institution. She is pursuing advanced education and has obtained her certification in oncology. She has published on quality improvement, presented a poster, and participated on an expert panel. The poster presentation at the Providence Saint Joseph Hospital (PSJH) research conference received the Most Innovative Clinical Award., McManus M; Author Affiliations: Oncology and Infusion Services, Providence Regional Medical Center Everett Cancer Partnership, Everett, Washington (Sarver); Sarver Better Living Products LLC, Everett, Washington (Sarver); Outpatient Infusion Center, University of Washington Medical Center, Seattle, Washington (McManus); Nursing Services, Medical Oncology, Providence Regional Medical Center Everett, Everett, Washington (Toler); Everett Community College, Everett, Washington (Toler); Providence Regional Medical Center Everett, Everett, Washington (Johnson).; Mary Jo Sarver, MN, ARNP, AOCN, CRNI, VA-BC, LNC, is a nurse practitioner at Oncology and Infusion Services, Providence Regional Medical Center Everett Cancer Partnership, Everett, Washington. Ms Sarver has more than 37 years of experience in infusion therapy and oncology/hematology care. Her role focuses on continuity of care and seamless transitions for patients within and outside the acute care setting. She collaborates and acts as a consultant locally and on a system level for Providence, guiding staff development, competency assessment, and process improvement to improve outcomes in multiple areas of clinical practice, and new graduate transition to practice. She attends cancer care conferences, rounds in the clinics and hospital, and actively consults and sees patients and families for treatment and care planning. She has published, conducted research, and spoken on multiple topics within the United States. For decades, passion has prompted her to participate both locally on the PSINS, PSONS, and ACS boards and nationally assume various roles through INS and ONS. She is CEO of Sarver Better Living, a family-run company. Monica McManus, MHA, BSN, RN, OCN, is the assistant nurse manager for an Outpatient Infusion Center at the University of Washington Medical Center. Ms McManus has been working in the nursing profession since 2009. She has expertise in oncology and intensive care nursing. She has functioned in several nursing leadership roles, as assistant nurse manager for inpatient oncology, manager for inpatient Oncology and Surgical Services, and in her current role as assistant nurse manager in Outpatient Infusion. She has published on topics to help improve oncology nursing documentation and on central venous access devices. She has an interest in nursing leadership and in helping to enhance the nursing profession through continued research on quality improvement for oncology and infusion nursing. John Toler, MSN, RN, is an administrative supervisor of Nursing Services; a registered nurse in Medical Oncology at Providence Regional Medical Center Everett; and an associate faculty of Nursing Services at Everett Community College. Mr Toler has 15 years of experience in oncology/hematology care, 3 years in administrative nursing supervision, 3 years in clinical instruction in nursing education, and prior management experience, including the director of nursing services. He is the recipient of several nursing awards, including Nurse of the Year for Innovation within the Providence/Swedish community, and the Faculty Daisy Award in Nursing Education in 2022. His roles transcend several areas of nursing, including leadership, education, mentorship, innovation, research, community relations and development, and direct patient care in the acute care setting. His passion for research and innovation has led to various improvements in operational efficiency, policy revisions, educational system developments, and positive patient outcomes. He continues to volunteer time to the nursing community through educational lectures and clinical precepting for graduates pursuing bachelor's and master's degrees. Bethany Johnson, BSN, RN, OCN, is a nurse educator at Providence Regional Medical Center Everett, (PRMCE) in Everett, Washington. Ms Johnson has worked for more than 15 years as a nurse in Medical Oncology at Providence Regional Medical Center Everett. This year, she transitioned into the role of nurse educator. She works on a system level, developing and teaching new hire education, and on a hospital level as a hands-on resource. As a nurse leader, she has served on and chaired several committees within the institution. She is pursuing advanced education and has obtained her certification in oncology. She has published on quality improvement, presented a poster, and participated on an expert panel. The poster presentation at the Providence Saint Joseph Hospital (PSJH) research conference received the Most Innovative Clinical Award., Toler J; Author Affiliations: Oncology and Infusion Services, Providence Regional Medical Center Everett Cancer Partnership, Everett, Washington (Sarver); Sarver Better Living Products LLC, Everett, Washington (Sarver); Outpatient Infusion Center, University of Washington Medical Center, Seattle, Washington (McManus); Nursing Services, Medical Oncology, Providence Regional Medical Center Everett, Everett, Washington (Toler); Everett Community College, Everett, Washington (Toler); Providence Regional Medical Center Everett, Everett, Washington (Johnson).; Mary Jo Sarver, MN, ARNP, AOCN, CRNI, VA-BC, LNC, is a nurse practitioner at Oncology and Infusion Services, Providence Regional Medical Center Everett Cancer Partnership, Everett, Washington. Ms Sarver has more than 37 years of experience in infusion therapy and oncology/hematology care. Her role focuses on continuity of care and seamless transitions for patients within and outside the acute care setting. She collaborates and acts as a consultant locally and on a system level for Providence, guiding staff development, competency assessment, and process improvement to improve outcomes in multiple areas of clinical practice, and new graduate transition to practice. She attends cancer care conferences, rounds in the clinics and hospital, and actively consults and sees patients and families for treatment and care planning. She has published, conducted research, and spoken on multiple topics within the United States. For decades, passion has prompted her to participate both locally on the PSINS, PSONS, and ACS boards and nationally assume various roles through INS and ONS. She is CEO of Sarver Better Living, a family-run company. Monica McManus, MHA, BSN, RN, OCN, is the assistant nurse manager for an Outpatient Infusion Center at the University of Washington Medical Center. Ms McManus has been working in the nursing profession since 2009. She has expertise in oncology and intensive care nursing. She has functioned in several nursing leadership roles, as assistant nurse manager for inpatient oncology, manager for inpatient Oncology and Surgical Services, and in her current role as assistant nurse manager in Outpatient Infusion. She has published on topics to help improve oncology nursing documentation and on central venous access devices. She has an interest in nursing leadership and in helping to enhance the nursing profession through continued research on quality improvement for oncology and infusion nursing. John Toler, MSN, RN, is an administrative supervisor of Nursing Services; a registered nurse in Medical Oncology at Providence Regional Medical Center Everett; and an associate faculty of Nursing Services at Everett Community College. Mr Toler has 15 years of experience in oncology/hematology care, 3 years in administrative nursing supervision, 3 years in clinical instruction in nursing education, and prior management experience, including the director of nursing services. He is the recipient of several nursing awards, including Nurse of the Year for Innovation within the Providence/Swedish community, and the Faculty Daisy Award in Nursing Education in 2022. His roles transcend several areas of nursing, including leadership, education, mentorship, innovation, research, community relations and development, and direct patient care in the acute care setting. His passion for research and innovation has led to various improvements in operational efficiency, policy revisions, educational system developments, and positive patient outcomes. He continues to volunteer time to the nursing community through educational lectures and clinical precepting for graduates pursuing bachelor's and master's degrees. Bethany Johnson, BSN, RN, OCN, is a nurse educator at Providence Regional Medical Center Everett, (PRMCE) in Everett, Washington. Ms Johnson has worked for more than 15 years as a nurse in Medical Oncology at Providence Regional Medical Center Everett. This year, she transitioned into the role of nurse educator. She works on a system level, developing and teaching new hire education, and on a hospital level as a hands-on resource. As a nurse leader, she has served on and chaired several committees within the institution. She is pursuing advanced education and has obtained her certification in oncology. She has published on quality improvement, presented a poster, and participated on an expert panel. The poster presentation at the Providence Saint Joseph Hospital (PSJH) research conference received the Most Innovative Clinical Award., Johnson B; Author Affiliations: Oncology and Infusion Services, Providence Regional Medical Center Everett Cancer Partnership, Everett, Washington (Sarver); Sarver Better Living Products LLC, Everett, Washington (Sarver); Outpatient Infusion Center, University of Washington Medical Center, Seattle, Washington (McManus); Nursing Services, Medical Oncology, Providence Regional Medical Center Everett, Everett, Washington (Toler); Everett Community College, Everett, Washington (Toler); Providence Regional Medical Center Everett, Everett, Washington (Johnson).; Mary Jo Sarver, MN, ARNP, AOCN, CRNI, VA-BC, LNC, is a nurse practitioner at Oncology and Infusion Services, Providence Regional Medical Center Everett Cancer Partnership, Everett, Washington. Ms Sarver has more than 37 years of experience in infusion therapy and oncology/hematology care. Her role focuses on continuity of care and seamless transitions for patients within and outside the acute care setting. She collaborates and acts as a consultant locally and on a system level for Providence, guiding staff development, competency assessment, and process improvement to improve outcomes in multiple areas of clinical practice, and new graduate transition to practice. She attends cancer care conferences, rounds in the clinics and hospital, and actively consults and sees patients and families for treatment and care planning. She has published, conducted research, and spoken on multiple topics within the United States. For decades, passion has prompted her to participate both locally on the PSINS, PSONS, and ACS boards and nationally assume various roles through INS and ONS. She is CEO of Sarver Better Living, a family-run company. Monica McManus, MHA, BSN, RN, OCN, is the assistant nurse manager for an Outpatient Infusion Center at the University of Washington Medical Center. Ms McManus has been working in the nursing profession since 2009. She has expertise in oncology and intensive care nursing. She has functioned in several nursing leadership roles, as assistant nurse manager for inpatient oncology, manager for inpatient Oncology and Surgical Services, and in her current role as assistant nurse manager in Outpatient Infusion. She has published on topics to help improve oncology nursing documentation and on central venous access devices. She has an interest in nursing leadership and in helping to enhance the nursing profession through continued research on quality improvement for oncology and infusion nursing. John Toler, MSN, RN, is an administrative supervisor of Nursing Services; a registered nurse in Medical Oncology at Providence Regional Medical Center Everett; and an associate faculty of Nursing Services at Everett Community College. Mr Toler has 15 years of experience in oncology/hematology care, 3 years in administrative nursing supervision, 3 years in clinical instruction in nursing education, and prior management experience, including the director of nursing services. He is the recipient of several nursing awards, including Nurse of the Year for Innovation within the Providence/Swedish community, and the Faculty Daisy Award in Nursing Education in 2022. His roles transcend several areas of nursing, including leadership, education, mentorship, innovation, research, community relations and development, and direct patient care in the acute care setting. His passion for research and innovation has led to various improvements in operational efficiency, policy revisions, educational system developments, and positive patient outcomes. He continues to volunteer time to the nursing community through educational lectures and clinical precepting for graduates pursuing bachelor's and master's degrees. Bethany Johnson, BSN, RN, OCN, is a nurse educator at Providence Regional Medical Center Everett, (PRMCE) in Everett, Washington. Ms Johnson has worked for more than 15 years as a nurse in Medical Oncology at Providence Regional Medical Center Everett. This year, she transitioned into the role of nurse educator. She works on a system level, developing and teaching new hire education, and on a hospital level as a hands-on resource. As a nurse leader, she has served on and chaired several committees within the institution. She is pursuing advanced education and has obtained her certification in oncology. She has published on quality improvement, presented a poster, and participated on an expert panel. The poster presentation at the Providence Saint Joseph Hospital (PSJH) research conference received the Most Innovative Clinical Award.
Jazyk:	angličtina
Zdroj:	Journal of infusion nursing : the official publication of the Infusion Nurses Society [J Infus Nurs] 2024 Nov-Dec 01; Vol. 47 (6), pp. 397-407. Date of Electronic Publication: 2024 Oct 30.
DOI:	10.1097/NAN.0000000000000562
Abstrakt:	A quasi-experimental study comparing the mixing and discard methods of laboratory specimen techniques in an adult acute care setting was conducted over a 30-month period. Primary end points were delta hemoglobin (Hgb) and transfusion rates. Secondary end points were redraws related to hemolysis and erroneous results, noting central venous access device (CVAD) type. Primary objectives included the comparison of hospital-acquired anemia and transfusion rates utilizing Hgb and venous sampling methods as part of a patient blood management (PBM) program. Secondary objectives tracked the type of CVAD used to acquire venous specimens and the impact on hemolysis rates or erroneous results. Considerations include exploring the benefits of utilizing the mixing method related to cost savings. In summary, the mixing versus discard method eliminates wasting blood to reduce hospital-acquired anemia as part of a PBM program. CVAD type did not influence hemolysis rates or impact erroneous results. The mixing method is easy to implement in any health care setting. Cost savings are feasible by elimination of external venous or arterial blood management protection devices. Removal of add-on devices supports standards by decreasing access points to reduce infection risk. Results, although inconclusive to superiority, demonstrated noninferiority and encouraged consideration of the mixing method for laboratory specimen collection. Competing Interests: Conflicts of interest:The authors report no conflicts of interest. (Copyright © 2024 Infusion Nurses Society.)
Databáze:	MEDLINE
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