Development, implementation and impact of Phlebotomy training on blood sample rejection and Phlebotomy knowledge of primary health care workers at selected primary health care facilities in Cape Town: a quasi-experimental study design

Abstract

Background: There is an increasing amount of blood sample rejection at primary health care facilities (PHCFs) impacting negatively on the staff, facility, patient and laboratory costs. Aim: The primary objective was to determine the rejection rate and reasons for blood sample rejection at four PHCFs pre and post phlebotomy training. The secondary objective was to determine whether phlebotomy training improved knowledge amongst primary health care providers (HCPs) and to develop a tool for blood sample acceptability. Study Setting: Two Community Health Centres (CHCs) and two Community Day Centres (CDCs) in Cape Town. Methods: A quasi-experimental study design. Results: The sample rejection rate was 0.79% (n= 60) at CHC A, 1.13% (n= 45) at CHC B, 1.64% (n= 38) at CDC C and 1.36% (n= 8) at CDC D pre training. The rejection rates remained approximately the same post training (p>0.05). The same phlebotomy questionnaire was administered pre and post training to HCPs. The average score increased from 6 3% (95% CI 6.97 - 17.03) to 96% (95% CI 16.91 - 20.09) at CHC A (p 0.039), 58% (95% CI 9.09 – 14.91) to 93% (95% CI 17.64 – 18.76) at CHC B (p 0.006), 60% (95% CI 8.84 – 13.13) to 97% (95% CI 16.14 – 19.29) at CDC C (p 0.001) and 63% (95% CI 9.81 – 13.33) to 97% (95% CI 18.08 – 19.07) at CDC D (p 0.001). Conclusion: There is no statistically significant improvement in the rejection rate of blood samples (p>0.05) post training despite knowledge improving in all HCPs (p <0.05).