An evaluation of the knowledge and practices of primary health care nurses in the collection of clinical specimens at the King Cetshwayo District, KwaZulu-Natal, South Africa

Abstract

The burden of diseases in South Africa (SA) increases the demand for several clinical specimens to be collected and analysed at the clinic level and to provide an initial diagnosis of diseases. The primary purpose of the clinical specimen collection is to conclude on the clinical diagnosis, give proper clinical management, and monitor disease progression of patients. In 2019, the South African National Health Laboratory Services reported an increasing rate of specimen rejection due to pre-analytic errors for Primary Health Care (PHC) clinics. The insufficient knowledge and incorrect practices by nurses during specimen collection resulted in specimens being deemed unsuitable for analysis thus were rejected by the laboratory services, leading to delayed patient diagnosis and treatment. Aim of the study The study aims to evaluate the knowledge and practices of nurses in the collection of clinical specimens that may lead to rejections in Primary Health Care clinics. Method Quantitative, non-experimental, cross-sectional descriptive survey design was used to conduct the study. Consecutive sampling method used to select the 22 fixed primary health care (PHC) clinics and one CHC under King Cetshwayo Health District. The target population consisted of professional and enrolled nurses from the selected clinics. Sample size was 352 respondents. A checklist and a self administered questionnaire was used to gather information on specimen collection. Data was analysed using SPSS version 27 and descriptive statistics was used to describe the data graphically and in frequency distribution tables Results The study results on knowledge and practices of nurses in specimen collection, showed that the majority of respondents (97%) n=326 displayed necessary knowledge on four main areas of specimen collection which are: preparation and identification; collection and handling; courier and results handling and the availability of specimen collection material. The respondents also displayed significant knowledge in the specimen collection and handling section with an 89% (n=299) response to colour coding for specimens and 81% (n=272) for the volume of the specimen in the container. Conclusion The study showed that three phases of specimen collection which are: specimen and patient preparation (pre-analytical), collection and analysis (analytical) as well as results handling (post-analytical) can influence each other negatively or positively. The positive influence is when the availability of all specimen collection consumables, proper nurses training (structure) and use of correct procedures (process) enables nurses to collect the specimens correctly so that accurate results will be produced (outcome). The negative influence is when the unavailability of some specimen collection consumables and inadequate training results in nurses using incorrect procedures to collect specimens; therefore, inaccurate results will be produced by the laboratory delaying patients’ diagnosis and treatment.