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. However, if treated early and aggressively, the survival rate approaches that of the regular heart failure population.Sample labeling errors have long plagued the laboratory industry putting patients at risk of transfusion-related death, medication errors, misdiagnosis, and patient mismanagement.
The average survival is less than a year in untreated patients with severe cardiac impairment. Therapeutic phlebotomy and iron chelation are the cornerstones of therapy.
Phlebotomy magnetic name tags serial#
In addition to its value in diagnosis of cardiac iron overload, response to iron reduction therapy can be assessed by serial imaging. Cardiac magnetic resonance imaging with measurement of T2* relaxation times can help quantify myocardial iron overload.
Newer modalities like strain imaging and speckle-tracking echocardiography hold promise for earlier detection of cardiac involvement. Patients should undergo comprehensive 2D and Doppler echocardiography to evaluate their systolic and diastolic function. Genetic testing for mutations in the HFE (high iron) gene and other proteins, such as hemojuvelin, transferrin receptor, and ferroportin, should be performed if secondary causes of iron overload are ruled out. Diagnosis of iron overload is established by elevated transferrin saturation (>55%) and elevated serum ferritin (>300 ng/mL). This is initially characterized by diastolic dysfunction and arrhythmias and in later stages by dilated cardiomyopathy. Cardiac hemochromatosis or primary iron-overload cardiomyopathy is an important and potentially preventable cause of heart failure.
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