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12 million adults

are affected by outpatient diagnostic errors annually in the United States.6

Up to 75% of lab diagnostic

errors occur in the preanalytical phase.7, 8

30–50% of all the antibiotics

prescribed for people are not needed or are not optimally effective as prescribed. 9, 10, 11

Proper cleaning and decontamination of a patient's skin, such as before providing a urine sample or drawing a blood sample, helps reduce contamination rates.

44% of ER and inpatients were prescribed inappropriate antibiotics due to contaminated urine cultures.1

The specimen collection method can impact specimen integrity.

56% of blood collections are from patients with diagnoses associated with difficult venous access2 (e.g., cancer, chronic cardiovascular disease, chronic kidney disease, diabetes, blood disorders/anemias and obesity).

The transport method can impact turnaround time and specimen quality, resulting in unnecessary recollects or inappropriate patient therapy.

Bacteria doubles in an unpreserved urine specimen every 20 minutes at room temperature.3

The testing method, timing and process can impact the time to reporting.

A 10-min reduction in lab result turnaround time = 6.7 min reduction in ED length of stay.4

Time to reporting of results can have an impact on clinical decisions and therefore patient treatment.

Many physicians surveyed believed that laboratory turnaround time caused delayed ED treatment more than 50% of the time and increased ED length of stay more than 50% of the time.5

TOWARD BETTER RESULTS

  • Reducing lab turnaround time and emergency department length of stay
  • Minimizing specimen contamination rate
  • Improving patient and healthcare worker experience
  • Maximizing diagnostic accuracy
References

1. Klausing BT, Tillman SD, Wright PW, Talbot TR. The influence of contaminated urine cultures in inpatient and emergency department settings. Am J Infect Control. 2016;44(10):1166-1167. doi: 10.1016/j.ajic.2016.03.055.
2. Data on File: REF-1882 BD Venipuncture Burden Insurance Data, U.S. 2012.
3. Bryan C. Infectious disease, chapter 7: urinary tract infections. In: Microbiology and Immunology On-line. Columbia, SC: University of South Carolina School of Medicine; 2017. Accessed on April 17, 2017 at http://microbiologybook.org/Infectious%20Disease/Urinary%20Tract%20Infections.htm.
4. Mitra D, Erdal E, Khangulov V, Tuttle R. Association between laboratory test turnaround time and emergency department length of stay: a retrospective US electronic health database analysis. Poster session presented at: American Association for Clinical Chemistry 2015 Annual Meeting and Clinical Lab Expo; July 26-30, 2015; Atlanta, GA.
5. Steindel SJ, Howanitz PJ. Physician satisfaction and emergency department laboratory test turnaround time. Arch Pathol Lab Med. 2001;125(7):863-871.
6. Singh H, Meyer AN, Thomas EJ. The frequency of diagnostic errors in outpatient care: estimations from three large observational studies involving US adult populations. BMJ Qual Saf. 2014;23(9):727-731. doi: 10.1136/bmjqs-2013-002627.
7. Lippi G, Chance JJ, Church S, et al. Preanalytical quality improvement: from dream to reality. Clin Chem Lab Med. 2011;49(7):1113-1126. doi:10.1515/CCLM.2011.600.
8. Bonini P, Plebani M, Ceriotti F, Rubboli F. Errors in laboratory medicine. Clin Chem. 2002;48(5):691-698.
9. Centers for Disease Control and Prevention (CDC). Antibiotic Resistance Threats in the United States, 2013. Available at https://www.cdc.gov/drugresistance/threat-report-2013. Published September 16, 2013. Accessed September 18, 2018.
10. Centers for Disease Control and Prevention (CDC). 1 in 3 antibiotic prescriptions unnecessary. Available at https://www.cdc.gov/media/releases/2016/p0503-unnecessary-prescriptions.html. Last reviewed January 1, 2016. Accessed September 18, 2018.
11. Fleming-Dutra KE, Hersh AL, Shapiro DJ, et al. Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010-2011. JAMA. 2016;315(17):1864-1873.

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