Physical Education, Health and Social Sciences 132
[Link] E-
ISSN: 2958-5996
P-ISSN: 2958-5988
A Review on Safety and Best Practices in Blood Collection and Handling
Kainat Hasti Khan1, Shah Muhammad Zakariya2, Talha Saleem3
1, 2, 3
DMLT-FAHS, The Superior University, Lahore, Email: bsmls-f21-248@[Link],
shahmuhammadzakariyaofficial@[Link], [Link]@[Link]
DOI: [Link]
Abstract:
Blood collection and handling are foundational elements of clinical diagnostics, forming the
basis for over 70% of medical decisions globally. Ensuring safety and following best practices
during each phase, pre-collection, collection, and post-collection, are essential for reliable and
accurate laboratory results. This review explores critical aspects of the blood collection process,
focusing on minimizing errors, protecting both patients and healthcare workers, and maintaining
specimen integrity. Pre-collection safety measures such as proper patient identification,
equipment preparation, hygiene of the staff, and accurate site selection reduce the chances of
contamination and ensure correct patient-sample matching. During collection, employing aseptic
techniques, using the correct order of draw, selecting the appropriate blood tubes, and effective
labeling are key to preserving sample quality and avoiding diagnostic delays. Patient comfort is
also emphasized to improve compliance and reduce procedural complications. Post-collection
handling addresses biohazard management, appropriate storage conditions, temperature control,
and transport protocols that prevent hemolysis, clotting, or contamination. These practices reduce
pre-analytical errors, which constitute a major proportion of total laboratory errors. The article
further discusses challenges faced in clinical settings, including human error, insufficient
training, needle-stick injuries, and improper transport procedures. Recent advancements such as
the introduction of safety-engineered devices, barcode labeling, and digital tracking systems,
have significantly improved process efficiency and safety. Guidelines from recognized bodies
like the World Health Organization (WHO), Clinical and Laboratory Standards Institute (CLSI),
and Centers for Disease Control and Prevention (CDC) are incorporated to support global
standardization. By reviewing the latest literature and practice guidelines, this article provides a
comprehensive resource for medical professionals. Adhering to these evidence-based protocols
can substantially reduce diagnostic inaccuracies, safeguard healthcare providers from blood
borne pathogens, and ultimately enhance patient care and laboratory service quality.
Key words: Pre-analytical errors, Sample handling, Best laboratory practices, Aseptic technique
Introduction to Blood Collection and Handling
Blood collection serves as a vital procedure in both diagnostic and therapeutic settings,
contributing to approximately 70% of clinical decisions worldwide. Whether for routine blood
tests, disease diagnosis, or therapeutic drug monitoring, the process must be carried out with
precision and safety to ensure valid results. The pre-analytical phase including patient
identification, sample collection, and labeling holds the highest probability for error in laboratory
testing. Studies have shown that nearly 46–68% of total laboratory errors occur during this
phase, often due to improper handling or collection techniques (1). These mistakes can have
serious implications such as delayed diagnosis, unnecessary repeat testing, and even patient
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harm. Maintaining the safety of both patients and healthcare providers during blood collection is
essential. One of the major concerns for medical staff is the risk of occupational exposure to
bloodborne pathogens like hepatitis B virus (HBV), hepatitis C virus (HCV), and human
immunodeficiency virus (HIV). The World Health Organization estimates that up to 40% of
hepatitis B and C infections in healthcare workers are attributable to needlestick injuries (2). This
risk is significantly higher in countries with limited access to safety-engineered devices or
insufficient training programs. Therefore, adopting universal precautions, using personal
protective equipment (PPE), and implementing post-exposure prophylaxis (PEP) protocols are
critical to reducing these risks. International guidelines emphasize standardization in blood
collection procedures to ensure both safety and quality. The World Health Organization (WHO)
recommends specific practices in its Best Practices in Phlebotomy document, including correct
patient positioning, use of sterile equipment, and proper disposal of sharps (3). Similarly, the
Clinical and Laboratory Standards Institute (CLSI) provides detailed protocols under the GP41-
A7 guideline, promoting the use of closed-system blood collection devices, pre-labeled tubes,
and continuous staff training (4). Such measures not only improve specimen quality but also
reduce the likelihood of exposure and contamination. Recent technological advancements also
support improved safety and reliability in blood collection. Barcode-based labeling systems, for
example, help reduce specimen misidentification, which is a common issue in manual systems.
Moreover, devices like safety needles, vacuum extraction tubes, and automatic lancets have
greatly reduced the risk of injury and contamination. Continuous research and adaptation of best
practices based on evidence from high-impact studies are essential for sustaining improvements
in blood collection and handling procedures globally (5). These advancements ensure that the
process remains efficient, patient-centered, and aligned with international safety standards.
Figure1. Blood collection and handling process
Pre-Collection Safety Measures
Ensuring accurate patient identification is the first and most critical step in the pre-collection
phase of blood sampling. Misidentification can lead to serious medical errors, including incorrect
diagnosis and inappropriate treatment. According to the Clinical and Laboratory Standards
Institute (CLSI), all patients must be identified using at least two independent identifiers, such as
full name and date of birth, before specimen collection begins (6). Verbal confirmation from the
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Volume 3, No. 3 July – September, 2025