Evaluation of a novel blood collection set for venipuncture in oncology patients with difficult venous access: Impact on sample quality, phlebotomist satisfaction and patient pain perception

Purpose: Difficult venous access (DVA), characterized by non-visible and non-palpable veins, is common in oncology patients. The objectives of this study were to compare the performances of two blood collection sets in an oncology phlebotomy setting: BD Vacutainer® UltraTouch™ Push Button (UT-PBBCS) and BD Vacutainer® Safety-Lok™ Blood Collection Set (SLBCS). The two sets were evaluated to assess whether use of a smaller gauge (G) needle (down-gauging) may reduce patient pain and improve peripheral venous access experience during phlebotomy in oncology patients.

Methods: Questionnaires were used to record patient data (age, gender), phlebotomy procedural observations (venipuncture site, number of collected tubes, blood flow, needle repositioning, underfilled tubes), patient pain perception and phlebotomist difficulty perception scores (0-10 points scale). Specimen quality was evaluated by hemolysis index (HI) on Roche Cobas® 6000.

Results: Subject groups showed no statistical difference. SLBCS (21/23G) or UT-PBBCS (23/25G) were used in 264 (45.8%) and 313 (54.2%) subjects respectively. Lower gauge was preferred for DVA (hand venipuncture), and DVA was associated with tube underfilling but no with type of blood collection set. For UT-PBBCS, pain perception, patients' anxiety level and phlebotomists' difficulty grade were lower when compared to SLBCS (p < 0.001). Blood samples collected with UT-PBBCS showed less hemolysis compared to samples collected with SLBCS (p < 0.001).

Conclusion: Provision of a smaller gauge UT-PBBCS option during phlebotomy in oncology patients with DVA reduces procedural pain and anxiety and improved phlebotomist' experience during sample collection. Despite the down-gauging, hemolysis was lower for UT-PBBCS, keeping sample quality while improving DVA patient comfort.