Background: Clinical situations require the timely acquisition of venous blood samples. For certain patients, acquisition of venous blood samples is technically challenging and phlebotomists are unsuccessful. Physicians are then responsible for sample acquisition. The response of physicians who encounter this scenario has been largely unexamined.
Methods: We surveyed 93 physicians who serve as primary providers for hospitalized patients at the University of Michigan Health System. Using an anonymous questionnaire, respondents were questioned regarding their experience, comfort level, success rates with phlebotomy as well as their current practice patterns and opinions regarding difficult blood draws.
Results: Respondents collectively reported little experience. 54% had performed 5 or fewer venous blood draws. 56% of respondents estimated their success rate to be 0%, and 45% stated they strongly disagreed that they could perform blood draws in a timely manner. Physicians employed multiple strategies to acquire samples, including soliciting assistance from ancillary staff (53%), particularly the vascular access team (29%), and attempting themselves (29%), often from the artery (18%). Overall, respondents felt this situation contributed to inefficiency, with 36% spending >30 minutes resolving this issue and 91% stating they agreed or strongly agreed that their time could be spent more wisely. 90% of respondents agreed or strongly agreed that patient safety would benefit from a standardized approach to difficult blood draws.
Conclusions: When phlebotomists are unable to draw venous blood, further attempts by physicians are unlikely to be successful. Further investigation is needed to determine the optimal approach for sample collection in these patients.