At least in France and most european countries, blood draw is performed by nurses, and , of course in ICU they use the arterial lines available in almost 6O% of the patients and 100% of those suffering from shock.

In the 8O's i worked in an hospital in which atrerial blood gas samples were drawn by a "phlebotomist", even for our ICU, but the delays may be very long....

Furthermore, if nurses did not draw blood samples, they will not get used to,and will have just a "pills distribution and toilets work"......

In My ICU, nurses drawn blood samples and in the midnight run they look on computers for the results and trasmitted them to the physician on duty. interestingly, they comment the results or ask "why"... I think that they will be very disappointed if blood drawning will be done by phlebotomists..; moreover, somme ICU have their own deported lab, nurses doing the job for all the biological data ( ph, Pa02, ...Na. BUN, lactate and so on) or only for research. They appreciate to participate and it is a very good way to obtain their "good participation" for a clinical study.

For a 500 beds hospital with multiple blocks, how many phlebotomists on duty in the day and at night to avoid delay?

Blood drawn by nurses induce cost saving, lower delay, increase patient's care since nurses are aware of the results.

I will not change for a central phlebotomists units

In the departments: nurses, arterial blood withdrawal included, even for the children.

For the outpatients consulting the policlinic: "central phlebotomy unit" ( three nurses) from monday to friday, with appointment or in emergency ( decided by physycians);

In case of diffculties or impossibilities: physicians are required.

In most hospitals I work there are phlebotimist who come in to draw blood. But, in urgent situations the nurse will draw the blood especially in ICU when time is important and arterial lines are usually available. However, the attending physicians take full responsibility so when blood work is too difficlut then the physicians have to get it.

At least in France and most european countries, blood draw is performed by nurses, and , of course in ICU they use the arterial lines available in almost 6O% of the patients and 100% of those suffering from shock.

In the 8O's i worked in an hospital in which atrerial blood gas samples were drawn by a "phlebotomist", even for our ICU, but the delays may be very long....

Furthermore, if nurses did not draw blood samples, they will not get used to,and will have just a "pills distribution and toilets work"......

In My ICU, nurses drawn blood samples and in the midnight run they look on computers for the results and trasmitted them to the physician on duty. interestingly, they comment the results or ask "why"... I think that they will be very disappointed if blood drawning will be done by phlebotomists..; moreover, somme ICU have their own deported lab, nurses doing the job for all the biological data ( ph, Pa02, ...Na. BUN, lactate and so on) or only for research. They appreciate to participate and it is a very good way to obtain their "good participation" for a clinical study.

For a 500 beds hospital with multiple blocks, how many phlebotomists on duty in the day and at night to avoid delay?

Blood drawn by nurses induce cost saving, lower delay, increase patient's care since nurses are aware of the results.

I will not change for a central phlebotomists units

The recently published paper by my group provides an extensive reply to your question:

Simundic AM et al. Survey of national guidelines, education and training on phlebotomy in 28 European countries: an original report by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) working group for the preanalytical phase (WG-PA).

Clin Chem Lab Med. 2013 Aug 1;51(8):1585-93. doi: 10.1515/cclm-2013-0283.

I hope it helps!

Ana-Maria

Thanks for this survey but as you reported « In the responding EFLM member countries, the majority of phlebotomy is performed by nurses and laboratory technicians.”, whereas in Denmark laboratory technicians are responsible for phleobotomy. According to your data, specialized phlebotomists are responsible of less than 10% of the phlebotomy…

I am sorry, but I do not believe that we need ‘professional phlebotomists” which will increase delays, costs and will not decrease the nurse/patient’s ratio required for ED, ICU or even standard wards. I completely disagree with the usefulness of the well established or emerging profession of phlebotomists. At least in my institution (Assistance Publique, Hopitaux de Paris), phlebotomy guidelines were implemented as well as “good practices for laboratory process.

PS: I agree with your analysis concerning the validity of your analysis, in view of its design to collect the responses : a member of your society for his or her country .

In our Hospital (Children's Hospital Zagreb) vein puncture is performed by laboratory technicians for outpatients and by nurses for inpatients. Capillary blood samples (complete blood count, glucose, pH, blood gas, CRP) draws laboratory technicians. Arterial blood samples for blood gas draws only physicians (anesthesiologists in ICU).

The point is we should work as a team and whoever is best at drawing blood should be the one to get it done instead of letting our patients to suffer.

I am very sorry, but as an ex- Head director of an ICU , Emergency Department and responsible of large medical department , french laboratory technicians are not formed for vein or arterial punctures. The patients will suffer ++++

Phlebotomists should be presents immediately 24h/24 in each department or unit, an hypothesis impossible in big institutions,

thus blood drawning should be done by nurses, even arterial blood samples.

ED and ICU nurses are allowed and trained to arterial punctures, at least in France. Furthermore, in time of costs saving, a central phlebotomists unit is unaffordable.

In the pediatric department of my institution, vein punctures and capillary blood samples are performed by nurses, whereas Arterial blood samples are drawns by physicians .

In our institution, we do not have separate Phlebotomy personnel.  The Medical Technologists, and one Laboratory Technician are the primary sources of our patient blood draws.  However, during short-staff days, we sometimes utilize a Radiology Technician and/or a Registered Nurse.

Thus, you have Medical Technologists (MT) and Nurses. Can you tell us your MT duties and their responsibilities.

Furthermore, what is the median delay between the physician’s drawing order and the MT, Laboratory technician (LT), Radiologist Technician (RT) or “Registered” Nurse (RN) blood draws?

Do you wait for the MT, LB, RT or RN, when a patient at evidence is gasping and need immediate intubation? In this hypothesis, it will be harmful. On the other hand, you automatically shadowed important biological data such as PaC02 and or lactate, for instance.

I am sorry, but as a previous Head Director of Paris area’s University ED and ICU in which all physicians and nurses are allowed to drawn immediately blood samples when necessary, I do not believe that we have time to wait for MT, LB, RT or RN…

With more than 200 patients/day in an ED with 12 boxes for the more severely ill, how many MT or LB should be present to avoid ED congestion?

How many MT or LB, works during the nighttime for your ED, ICUs and the other wards of your institution (how many beds?)