Ms Alycia Jacob

Aims: To explore the relationship between blood sampling techniques and haemolysis. Background: Haemolysis rates of blood samples have been thought to be influenced by the method of collection. There is a lack of research evidence available to clearly show the comparative risk of haemolysis across different blood sampling methods, including venepuncture and use of peripheral intravenous cannulas. Design: A prospective cohort study. Reporting followed the STROBE checklist. Methods: A trained observer was used to record blood sampling techniques over a 10-week period between April and June 2019. These records were then linked to pathology haemolysis results. Multivariable logistic regression was used to model patient and blood draw characteristics affecting haemolysis. Results: Most of the blood samples were not haemolysed (n¿=¿324, 87.1%). Multivariable analysis showed haemolysis was associated with increased tourniquet duration and if the level of tube was less than half full. Univariable analysis showed haemolysis was associated with increased age of the patient, the difficulty of cannulation/ venepuncture and increased number of attempts. No difference was found in the haemolysis rate related to the qualification of the blood collector. Conclusion: There was no significant difference in haemolysis rates associated with sampling blood from a PIVC compared with venepuncture. Research should be undertaken to determine whether education on the factors influencing haemolysis is useful in decreasing haemolysis rates. Relevance to clinical practice: There was no association with increased haemolysis rates when drawing blood via venepuncture compared with a peripheral intravenous cannula. Haemolysis of blood samples was associated with increased tourniquet duration, if level of the tube was less than half-filled, increased age of the patient and difficulty of blood draw. Awareness of the risk of haemolysis associated with specific blood sampling methods may assist clinicians to improve care.

Background: The prevalence of dementia is increasing with more healthcare workers being required to care for people living with this progressive neurological disorder. The knowledge level and attitude of healthcare workers caring for those living with dementia need to be assessed and resources targeted effectively to ensure best quality care is provided. Healthcare workers for the purpose of this paper include anyone employed to care for those living with dementia. Aim: To investigate the attitudes of healthcare workers towards people living with dementia. Methods: A survey of 110 healthcare workers was undertaken between October 2016 and December 2017, using the Dementia Attitude Scale to measure attitudes towards people living with dementia. Demographic data were collected by a survey to explore whether a person¿s age; cultural background; qualification level; or experience level had an impact on their attitude towards people living with dementia. Results: The full survey was completed by n = 85 healthcare workers with the majority having strongly positive views about people living with dementia, with an average score of 88.31/100. However, a large number reported being afraid of people living with dementia (n = 76, 89.4%) and would avoid people with dementia who were agitated (n = 51, 61.4%). While 100% (n = 85) agreed or strongly agreed that it was possible to enjoy interacting with people living with dementia, they were more ambivalent with n = 26 (31.6%) strongly agreeing with the statement that working with people living with dementia is rewarding. A significant difference in attitude was found using one-way analysis of variance within groups due to age (p <.000) and cultural background (p <.035). Conclusions: Healthcare workers within this study had mainly positive attitudes towards people with dementia as demonstrated by the high attitude scores. However, this paper has shown that healthcare workers may require further education to improve attitude and care towards those living with dementia.

Background: Peripheral intravenous cannulas are commonly used for blood sampling. Conflicting evidence on the safety and reliability of blood sampling from peripheral intravenous cannulas provides little support to guide practice of clinicians. Aim: To elicit views of nurses working in acute care of their opinions on the safety and efficacy of obtaining blood samples from peripheral intravenous cannulas. Methods: A cross-sectional electronic survey was utilised. Participants included nurses working in Australian acute care services nationally. The STROBE checklist was followed. The survey was distributed by two professional nursing bodies to their members between September and December 2017. Content analysis was used to analyse open-ended responses. Findings: Of the 338 participants who completed the survey, 269 provided comments. Themes supporting the use of peripheral intravenous cannulas for blood sampling included ¿efficiency¿, ¿patient care¿, ¿last resort¿, and ¿other¿. Reasons for not using a peripheral intravenous cannula for sampling provided themes of ¿PIVC use¿, ¿dwell time¿, ¿test type required¿, ¿patency/insertion site care¿, ¿preference¿, and ¿other¿. Discussion: The choice regarding method of blood sampling is left to the discretion of individual practitioners. Diverse rationales were provided by respondents to support their practice in sampling blood. This may be influenced by variations in hospital policies and conflicting research evidence to support or refute the practice. Conclusion: Blood sampling from peripheral intravenous cannulas or venepuncture is practiced differently between nurses based on multiple rationales. Research is needed to provide evidence for safe practice and support hospital policies.