Impact of the COVID-19 pandemic on the performance of venous sampling: fact checking survey analysis of the GdS Extra-Analytical Variability. Impatto della pandemia COVID-19 sull'esecuzione del prelievo venoso: analisi conoscitiva del GdS Qualità Extra-Analitica

Background: The Extra-Analytical Quality Study Group (GdS QuEA) has as its objective the identification and relative control of extra-analytical variables, although it does not directly concern the laboratory itself. To evaluate whether the pandemic could have worsened the correct execution of venous sampling, due to the hiring of new staff at a critical moment, the total requests for blood count, potassium and coagulative tests were evaluated over a five-year period (2018-2022), with particular attention to those coming from the Emergency Department (ED) in five Italian laboratories in Bolzano, Siena, Ancona, Nola and Caltanissetta; five large, medium-sized hospitals and small in size, located along the entire peninsula. Methods: The main non-conformities that may concern the blood count, serum and coagulation samples were evaluated, considering the presence of clots, hemolysis and low volume respectively, which do not make the sample itself analysable. The non-conformities relating to the years 2018, 2019, 2020, 2021 and 2022 were extracted and compared from the management software of the various laboratories. The computer systems used are: Dedalus spa for Bolzano; TDSynergy Siemens for Siena; Modulab Werfen for Nola and Caltanissetta, Alchymia fornito da SCS Computers for Ancona. Results: In all five hospitals there was a clear reduction in requests during the year 2020, which represents the watershed between the pre- and post-pandemic period. Obsiously, the absolute values of requests vary greatly based on the catchment areas that the hospitals cover, as do the percentages of requests coming from the Emergency Department, which range from 10 to almost 50%. The Emergency Department has the greatest non-conformities, although this concept cannot be generalized to all hospitals. Noncompliances increased at different percentages after 2020. Conclusions: This fact-finding investigation into the main non-conformities that may concern venous sampling has allowed us to collect and analyze some data regarding our territory. After the pandemic we have had an increase in non-compliance, but the non-uniformity of the various hospitals does not allow us to intervene in a univocal manner at a national level, suggesting that each hospital should carry out its own assessments and implement its own improvement interventions.