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Blood: testing and exposure


​Appropriateness of community and inpatient lab test ordering

Very significant concerns have been raised in regard to Community Laboratory Testing. An audit of practice over a three-month period revealed that 15 physicians were very significantly above the mean for laboratory test ordering. While we understand that someone needs to be the highest and someone else needs to be the lowest there is concern in regards to the appropriateness in that ordering.

The Appropriateness Team is in the process of reviewing the ordering on once the team ensures that there are no issues within the data, and the team will then carefully and in detail examine the reasons for the apparent practice variation.

There are initiatives underway to review lab test ordering particularly pre-operative testing and routine daily blood work ordered on inpatients.

These efforts will hopefully lead to safer and more cost-effective management of our laboratory resources.

Submitted by: Dr David McCutcheon VP Physician and Integrated Health Services

2015 Blood and Body Fluid Exposure Report

The 2015 Summary of RQHR Blood and Body Fluid Exposures (BBFEs). Please note, all of the Annual totals were based on a summation of the Quarterly numbers.

  • There were a total of 124 Contaminated BBFEs. This is a significant decrease compared to 2014 where there were 168 BBFEs—a decrease of 26%. This decrease in number may in part be related to our more precise coding options and definitions in relation to Non-Contaminated exposures and Potential BBFEs.
  • With respect to site location, the RGH had the most notable decrease in BBFEs, going from 102 in 2014 to 66 in 2015.
  • The Emergency, Operating Room, and Labour and Birth departments had the highest number of BBFEs.
  • Registered Nurses had the highest number of BBFEs with 44 of the 124 exposures. Next were Physicians, College of Medicine Students, and Licensed Practical Nurses.
  • Lack of use of Safety Glasses and/or Face Shield was the leading action contributing to exposure.
  • There was a total of 104 Potential BBFEs, almost the same as in 2014.
  • As always, Managers and staff need to review the Statistics – take an in-depth look at the Incidents that have happened in their areas; post and focus on them at their Visibility Walls and Huddles; review the general Safe Work Practices at the end of the Report; develop specific plans, safe work practices, and Work Standards for their areas to continue to reduce the rates of actual and potential BBFEs.

If you have any questions regarding the BBFE report please contact Carol Ann Spicer, Occupational Health Nurse (Pasqua Hospital).