LMBP criteria were used to make conclusions on the overall strength of evidence on effectiveness which is based on the total body of evidence by taking into account the number of studies included in the evidence, quality of available evidence, consistency of results, magnitude of effect estimates, and applicability considerations. The effect size strength rating for each individual study was based on the range of percentage change in labeling errors due to the intervention, the reduction in labeling errors between 0% to ≤ 40% was considered ‘minimal’ magnitude of effect any decrease in labeling errors between >40% to ≤ 75% was considered ‘moderate’ magnitude and finally any decrease in labeling errors > 75% was considered ‘substantial’ magnitude of effect. Where the Intervention Pre and Intervention Post represent the percent of labeling errors before and after the intervention implementation respectively. Intervention Post - Intervention Pre/Intervention Pre X 100 A total of 10,854 relevant records (both published and unpublished) were retrieved as a result of formal and informal literature searches.
We also received relevant unpublished data from the researchers, laboratories, and institutions in the field through personal requests and LMBP™ website but none of the unpublished data qualified to be included in this review. In addition, the systematic review team retrieved evidence from other informal sources such as hand searches including relevant references from all retrieved articles and additional studies identified by subject matter experts on the e-SBI systematic review team were incorporated into the review. Search details are available at Supplemental Appendix C. Published evidence was searched between the time periods of 1990 to September 2015 using the following databases: Medline OVID (R), Embase OVID, CINAHL EbscoHost, Cochrane Library Database, Dissertation Abstracts, and PubMed to identify studies relevant to evaluations of interventions to reduce specimen mislabeling. 9 Generally the improved collaboration in the form of MDT result into emphasize that health-care providers have primary responsibility for checking/verifying a patient’s identity, development of standardized organization policies and protocols to emphasize the importance of positive patient identification that are compatible with the values and needs of the medical facilities, e.g., requirement of unique patient identifiers on specimen labels, implementation of zero tolerance policy, staff performance assessment, availability of adequate number of qualified personnel to perform specimen collection, reinforcement of specimen labeling at the bed side, delta checks etc. MDT approach help to improve the communication and collaboration between the key stakeholders including pathologists, radiologists, diagnosticians, management, and treating health care professionals (clinicians and nurses) to reduce diagnostic errors related to patient misidentification due to labeling errors. Improved Communication and Collaboration between Laboratory and Healthcare Professionals: Formation of Multidisciplinary Teams (MDT) The objective of this review is to identify and evaluate the effectiveness of existing interventions /practices to develop evidence based recommendations for the best laboratory practices to reduce sample labeling errors.
8Ī thorough literature review and establishment of Best Practices for the industry are necessary to protect patients from the threats of specimen labeling errors. 6, 7 However, between 20 the incidence of wrong-blood-in-tube errors (WBIT) remained unchanged even though barcode scanner usage increased from eight percent to 38 percent during the same period. The use of barcoding systems for specimen labeling and point-of-care test barcoding was established by the Centers for Disease Control and Prevention (CDC) as a Best Practice in 2010 to reduce identification errors and improve the accuracy of patient specimen and laboratory testing identification in hospital settings. 3, 4 A 2009 Q-Probes study found the rate of tube mislabeling of blood bank samples to be 1.12 percent. 2 Inadequately labeled samples account for 5.6–6.7% of all rejected samples. 1 Eleven percent of all transfusion deaths occur as a result of the phlebotomist not properly identifying the patient or mislabeling the tube of blood. because of patient or specimen identification errors involving the laboratory. It has been estimated over 160,000 adverse patient events occur each year in the U.S. Sample labeling errors have long plagued the laboratory industry putting patients at risk of transfusion-related death, medication errors, misdiagnosis, and patient mismanagement.
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