VALIDATION OF PHLEBOTOMY PERFORMANCE METRICS DEVELOPED AS PART OF A PROFICIENCY BASED PROGRESSION INITIATIVE TO MITIGATE WRONG BLOOD IN TUBE

Aims The purpose of this study was to 1) characterise the procedure of phlebotomy, deconstruct it into its constituent parts and develop a performance metric for the purpose of training healthcare professionals in a large teaching hospital, 2) evaluate the construct validity of the phlebotomy metric and establish a proficiency benchmark. Method Using video recordings of the procedure, we defined a performance metric. This was brought to a modified Delphi meeting, where consensus was reached by an expert panel. To demonstrate construct validity, we used the metric to objectively assess the performance of novices and expert practitioners. Results A phlebotomy metric consisting of 11 phases and 77 steps was developed. The mean inter-rater reliability was 0.91 (min 0.83, max 0.95). The Expert group completed more steps of the procedure (72 Vs 69), made 69% fewer errors (19 vs 13, p = 0.014) and 300% fewer critical errors (1 Vs 4, p = 0.002) than the Novice Group. Conclusions The metrics demonstrated construct validity and the proficiency benchmark was established with a minimum observation of 69 steps, with no critical errors and no more than 13 errors in total.