Current methods of haemolysis detection and reporting as a source of risk to patient safety: a narrative review

Euan J. McCaughey, Elia Vecellio, Rebecca Lake, Ling Li, Leslie Burnett, Douglas Chesher, Stephen Braye, Mark Mackay, Stephanie Gay, Tony C. Badrick, Johanna I. Westbrook, Andrew Georgiou

Research output: Contribution to journalReview articleResearchpeer-review

Abstract

Aim Haemolysis has a major impact on patient safety as the need for a replacement specimen increases the risk of injury and infection, delays test results and extends the duration of hospital stays. Consistency of haemolysis detection and reporting can facilitate the generation of benchmark data used to develop quality practices to monitor and reduce this leading cause of pre-analytical laboratory error. This review aims to investigate current methods of haemolysis detection and reporting. Method Due to known heterogeneity and immaturity of the research field, a scoping search was conducted using PUBMED, Embase, Medline and CINAHL. Articles published between 2000 and 2014 that reported haemolysis rates in specimens from the general population were included. Results Of the 50 studies that met the inclusion criteria, 20 detected haemolysis using the Haemolysis Index (HI), 19 by visual inspection and 13 by undefined methods. There was large intra-study variation in the plasma free haemoglobin level used to establish haemolysis (HI: mean±SD 846±795 mg/L, range 150-3000 mg/L; Visual: 850±436 mg/L, 500-3000 mg/L). Sixteen studies reported the analyte of interest, with only three studies reporting a haemoglobin level at which the specimen would be rejected. Conclusion Despite haemolysis being a frequent and costly problem with a negative impact on patient care, there is poor consistency in haemolysis detection and reporting between studies. Improved consistency would facilitate the generation of benchmark data used to create quality practices to monitor and reduce this leading cause of pre-analytical laboratory error.

LanguageEnglish
Pages143-151
Number of pages9
JournalClinical Biochemist Reviews
Volume37
Issue number4
Publication statusPublished - Dec 2016

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Patient Safety
Hemolysis
Hemoglobins
Inspection
Plasmas
Benchmarking
Length of Stay
Patient Care
Wounds and Injuries

Keywords

  • Journal Article
  • Review

Cite this

McCaughey, Euan J. ; Vecellio, Elia ; Lake, Rebecca ; Li, Ling ; Burnett, Leslie ; Chesher, Douglas ; Braye, Stephen ; Mackay, Mark ; Gay, Stephanie ; Badrick, Tony C. ; Westbrook, Johanna I. ; Georgiou, Andrew. / Current methods of haemolysis detection and reporting as a source of risk to patient safety : a narrative review. In: Clinical Biochemist Reviews. 2016 ; Vol. 37, No. 4. pp. 143-151.
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McCaughey, EJ, Vecellio, E, Lake, R, Li, L, Burnett, L, Chesher, D, Braye, S, Mackay, M, Gay, S, Badrick, TC, Westbrook, JI & Georgiou, A 2016, 'Current methods of haemolysis detection and reporting as a source of risk to patient safety: a narrative review', Clinical Biochemist Reviews, vol. 37, no. 4, pp. 143-151.

Current methods of haemolysis detection and reporting as a source of risk to patient safety : a narrative review. / McCaughey, Euan J.; Vecellio, Elia; Lake, Rebecca; Li, Ling; Burnett, Leslie; Chesher, Douglas; Braye, Stephen; Mackay, Mark; Gay, Stephanie; Badrick, Tony C.; Westbrook, Johanna I.; Georgiou, Andrew.

In: Clinical Biochemist Reviews, Vol. 37, No. 4, 12.2016, p. 143-151.

Research output: Contribution to journalReview articleResearchpeer-review

TY - JOUR

T1 - Current methods of haemolysis detection and reporting as a source of risk to patient safety

T2 - Clinical Biochemist Reviews

AU - McCaughey, Euan J.

AU - Vecellio, Elia

AU - Lake, Rebecca

AU - Li, Ling

AU - Burnett, Leslie

AU - Chesher, Douglas

AU - Braye, Stephen

AU - Mackay, Mark

AU - Gay, Stephanie

AU - Badrick, Tony C.

AU - Westbrook, Johanna I.

AU - Georgiou, Andrew

PY - 2016/12

Y1 - 2016/12

N2 - Aim Haemolysis has a major impact on patient safety as the need for a replacement specimen increases the risk of injury and infection, delays test results and extends the duration of hospital stays. Consistency of haemolysis detection and reporting can facilitate the generation of benchmark data used to develop quality practices to monitor and reduce this leading cause of pre-analytical laboratory error. This review aims to investigate current methods of haemolysis detection and reporting. Method Due to known heterogeneity and immaturity of the research field, a scoping search was conducted using PUBMED, Embase, Medline and CINAHL. Articles published between 2000 and 2014 that reported haemolysis rates in specimens from the general population were included. Results Of the 50 studies that met the inclusion criteria, 20 detected haemolysis using the Haemolysis Index (HI), 19 by visual inspection and 13 by undefined methods. There was large intra-study variation in the plasma free haemoglobin level used to establish haemolysis (HI: mean±SD 846±795 mg/L, range 150-3000 mg/L; Visual: 850±436 mg/L, 500-3000 mg/L). Sixteen studies reported the analyte of interest, with only three studies reporting a haemoglobin level at which the specimen would be rejected. Conclusion Despite haemolysis being a frequent and costly problem with a negative impact on patient care, there is poor consistency in haemolysis detection and reporting between studies. Improved consistency would facilitate the generation of benchmark data used to create quality practices to monitor and reduce this leading cause of pre-analytical laboratory error.

AB - Aim Haemolysis has a major impact on patient safety as the need for a replacement specimen increases the risk of injury and infection, delays test results and extends the duration of hospital stays. Consistency of haemolysis detection and reporting can facilitate the generation of benchmark data used to develop quality practices to monitor and reduce this leading cause of pre-analytical laboratory error. This review aims to investigate current methods of haemolysis detection and reporting. Method Due to known heterogeneity and immaturity of the research field, a scoping search was conducted using PUBMED, Embase, Medline and CINAHL. Articles published between 2000 and 2014 that reported haemolysis rates in specimens from the general population were included. Results Of the 50 studies that met the inclusion criteria, 20 detected haemolysis using the Haemolysis Index (HI), 19 by visual inspection and 13 by undefined methods. There was large intra-study variation in the plasma free haemoglobin level used to establish haemolysis (HI: mean±SD 846±795 mg/L, range 150-3000 mg/L; Visual: 850±436 mg/L, 500-3000 mg/L). Sixteen studies reported the analyte of interest, with only three studies reporting a haemoglobin level at which the specimen would be rejected. Conclusion Despite haemolysis being a frequent and costly problem with a negative impact on patient care, there is poor consistency in haemolysis detection and reporting between studies. Improved consistency would facilitate the generation of benchmark data used to create quality practices to monitor and reduce this leading cause of pre-analytical laboratory error.

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JO - Clinical Biochemist Reviews

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