SHM Converge Scientific Abstract ePoster Gallery-Myths and Mitigation Efforts to Prevent Phlebotomy Associated Anemia

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Phlebotomy-associated anemia (PAA) from routine inpatient blood draws is a common but often overlooked problem that can contribute to worsening anemia, longer hospital stays, and higher costs. In this quality improvement project at a public safety-net hospital, 47 eligible patients admitted between May 2022 and March 2023 were reviewed. Eleven patients already had anemia on day 1. By day 5, 77% had a significant hemoglobin drop, and half of those patients developed new anemia. Overall, 46% of patients experienced either new or progressive anemia within five days, yet only 24% of patients with new anemia had documentation acknowledging it.<br /><br />The project aimed to identify the prevalence and impact of PAA and encourage use of “blood conservation” lab panels, which require about 3 mL of blood compared with 10 mL for standard testing. Initial education alone had limited effect, and conservation panel use remained low.<br /><br />Several interventions were then introduced: flyers and targeted education for providers, reminders through emails, huddles, and Epic chats, EMR changes to make conservation panels more comprehensive, and improved phlebotomy staffing with an added lab time slot. After these efforts, use of conservation lab panels increased.<br /><br />The main lesson learned was that PAA is frequently underrecognized and underdocumented, making improvement difficult without coordinated efforts. Successful mitigation requires ongoing communication among providers, nursing, phlebotomy staff, and leadership. Future plans include individual lab utilization reports, continued focused education, and further EMR optimization to preferentially select blood conservation panels for patients with anemia.

Asset Subtitle

Shaheen Fatima

Meta Tag

Author List Antinesha Wyatt, Iheoma Alinnor, Shaheen Fatima, Stephen Haff

Category Research

Concept Phlebotomy-Associated Anemia

Concept Anemia

Concept Blood Conservation Panel

Concept Routine Laboratory Draws

Concept Phlebotomy Volume

Distinguished Non-Finalist

Presenter Organization Emory University, Grady Memorial Hospital

Presenting Author Shaheen Fatima

Track Quality Improvement

Keywords

phlebotomy-associated anemia

inpatient blood draws

blood conservation panels

hemoglobin drop

new anemia

quality improvement

hospital stay

EMR optimization

provider education

lab utilization

Phlebotomy-Associated Anemia

Anemia

Blood Conservation Panel

Routine Laboratory Draws

Phlebotomy Volume