Bibliographic information Overall rating	Study* Category (points deducted)	Practice* Category (points deducted)	Outcome measures* Category (pts deducted)	Results/findings* Category (points deducted)
– Author(s): Anonymous  – Year: 2011  – Publication: Unpublished  –Affiliations: Dameron Hospital Assoc Stockton, CA.  – Funding: Internal	– Design: (0) Full review for 24-h period plus Semi-random case–control record review for nurse draws (case= hemolyzed, pulled next non-hemolyzed nurse draw to compare methods) – Facility/setting: (0) – Time period: (0) – Population/sample: (1) 1) all ED patients over two 24-h 2) all hemolyzed nurse draws and semi-randomly selected non-hemolyzed nurse draws / also phlebotomist draws – Comparator: (0) 1) Antecubital vs. other 2) ≤21 vs. >21 gauge Also 3) Straight needle vs. IV start – Study bias: (0) None observed.	-Description: (0) All nurse draws are by IV with 12 mL syringe. All phlebotomist draws are by straight needle venipuncture with vacuum tube or syringe. Two 24-h count to observe ratio of phlebotomist to nurse draws One-month review of hemolysis cases with semi-random case–control evaluation of practice parameters for nurse draws. – Duration: (0) Two 1-day reports 1 month (August 2011) case–control. – Training: (0) None – Staff/other resources: (0) Volunteer time of phlebotomy supervisor – Cost: (0) Minimal	– Description: (0) Hemolysis as determined by hospital lab. Use both visual and automated colorimetric analysis using a Beckman DXC. – Recording method: (0) Abstraction from records	– Type of findings: (0) 1) Case–control Odds Ratios (based upon %’s of a given practice among cases – hemolyzed samples – and controls – non-hemolyzed samples) 2) Rates of hemolysis (based upon estimates of number of nurse draws) – Findings/effect size: (0) 1) Antecubital vs. other (ORs) Odds Ratio=1.87 2) ≤21 vs. >21 gauge Odds Ratio=1.43 Above findings based upon 177 cases (hemolysis) and 177 controls (see attached calculations). 3) Straight needle vs. IV start Phlebotomist: 10/1292=0.8% Nurse: 39/431=6.7% Above findings based upon certain estimates from two 24-h observations (see attached calculations). – Statistical significance/test(s): (0) None conducted – Results/conclusion biases: (1) No evident bias. Elevated OR for non-antecubital sites PLUS suggestion of elevated OR for smaller needle size (larger gauge)
Quality rating: 8 (good)  Effect rating: Substantial, minimal/ none, substantial  Relevance: Direct	Study (3 max): 2 Need to estimate denominators for nurse draws to calculate RRs	Practice (2 max): 2	Outcome (2 max): 2	Results/findings (3 max): 2 Have to estimate denominator for nurses — part of the case–control design

^*Numbers in () by category headings reflect the number of points deducted from the maximum points for that column domain.