Mitigating the risk of tube shortages: A blood collection tube validation study conducted in South Africa

Background: The National Health Laboratory Service was using Becton Dickinson (BD) blood drawing tubes and, in 2021, the supplier notified customers of supply challenges, indicating a risk of global shortages. Objective: This study aimed to validate candidate blood collection tubes from four brands...

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Main Authors: Marizna Korf, Jody Rusch, Aye Aye Khine, Nalene Strauss, Lourens Jacobsz, Annalise E. Zemlin, Helena Vreede
Format: Article
Language:English
Published: AOSIS 2025-04-01
Series:African Journal of Laboratory Medicine
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Online Access:https://ajlmonline.org/index.php/ajlm/article/view/2628
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author Marizna Korf
Jody Rusch
Aye Aye Khine
Nalene Strauss
Lourens Jacobsz
Annalise E. Zemlin
Helena Vreede
author_facet Marizna Korf
Jody Rusch
Aye Aye Khine
Nalene Strauss
Lourens Jacobsz
Annalise E. Zemlin
Helena Vreede
author_sort Marizna Korf
collection DOAJ
description Background: The National Health Laboratory Service was using Becton Dickinson (BD) blood drawing tubes and, in 2021, the supplier notified customers of supply challenges, indicating a risk of global shortages. Objective: This study aimed to validate candidate blood collection tubes from four brands (VACUCARE, VACUETTE®, VACUTEST®, and V-TUBE™) compared to BD Vacutainer® tubes in three National Health Laboratory Service laboratories in Cape Town, South Africa. Methods: Blood was collected from 300 healthy volunteers between October 2021 and November 2021. The technical validation assessed 11 quality indicators, with a sigma metric greater than 4 deemed acceptable. Usability feedback was gathered from phlebotomists. The clinical validation estimated differences in results across 52 clinical chemistry tests, using desirable bias specified by the European Federation of Clinical Chemistry and Laboratory Medicine Biological Variation Database, or Ricos, as acceptance criteria. Analysis was performed on Roche cobas® 6000 and DiaSorin Liaison® XL analysers. Results: All VACUCARE tubes exhibited sigma metrics above 4, indicating excellent performance. VACUETTE® and V-TUBE™ were not uncapped by all Roche pre-analytical systems. VACUTEST® caps had rigid rubber, making it more challenging to puncture and detach the tube, which resulted in needle displacement. Both VACUCARE and V-TUBE™ were reported as user-friendly. All candidate tube analytes showed acceptable clinical performance. Conclusion: VACUCARE, VACUETTE®, VACUTEST® and V-TUBE™ are viable alternatives to BD Vacutainer®. However, based on the results obtained from the technical validation, VACUCARE was identified as the most suitable interim replacement for BD Vacutainer® during the shortage. What this study adds: This study addresses a gap in the literature on tube validation and provides valuable insights for clinical laboratories considering a replacement. It also presents an alternative approach to technical validation by utilising sigma metrics.
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2225-2010
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publishDate 2025-04-01
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series African Journal of Laboratory Medicine
spelling doaj-art-1a17cefff92d418ca160db985387d9e82025-08-20T02:16:09ZengAOSISAfrican Journal of Laboratory Medicine2225-20022225-20102025-04-01141e1e910.4102/ajlm.v14i1.2628496Mitigating the risk of tube shortages: A blood collection tube validation study conducted in South AfricaMarizna Korf0Jody Rusch1Aye Aye Khine2Nalene Strauss3Lourens Jacobsz4Annalise E. Zemlin5Helena Vreede6Division of Chemical Pathology, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa; Division of Chemical Pathology, National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa; Division of Chemical Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; and Division of Chemical Pathology, National Health Laboratory Service, Groote Schuur Hospital, Cape TownDivision of Chemical Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; and Division of Chemical Pathology, National Health Laboratory Service, Groote Schuur Hospital, Cape TownDivision of Chemical Pathology, National Health Laboratory Service, Green Point Laboratory, Cape TownDivision of Chemical Pathology, National Health Laboratory Service, Green Point Laboratory, Cape TownDivision of Chemical Pathology, National Health Laboratory Service, Green Point Laboratory, Cape TownDivision of Chemical Pathology, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa; and Division of Chemical Pathology, National Health Laboratory Service, Tygerberg Hospital, Cape TownDivision of Chemical Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; and Division of Chemical Pathology, National Health Laboratory Service, Groote Schuur Hospital, Cape TownBackground: The National Health Laboratory Service was using Becton Dickinson (BD) blood drawing tubes and, in 2021, the supplier notified customers of supply challenges, indicating a risk of global shortages. Objective: This study aimed to validate candidate blood collection tubes from four brands (VACUCARE, VACUETTE®, VACUTEST®, and V-TUBE™) compared to BD Vacutainer® tubes in three National Health Laboratory Service laboratories in Cape Town, South Africa. Methods: Blood was collected from 300 healthy volunteers between October 2021 and November 2021. The technical validation assessed 11 quality indicators, with a sigma metric greater than 4 deemed acceptable. Usability feedback was gathered from phlebotomists. The clinical validation estimated differences in results across 52 clinical chemistry tests, using desirable bias specified by the European Federation of Clinical Chemistry and Laboratory Medicine Biological Variation Database, or Ricos, as acceptance criteria. Analysis was performed on Roche cobas® 6000 and DiaSorin Liaison® XL analysers. Results: All VACUCARE tubes exhibited sigma metrics above 4, indicating excellent performance. VACUETTE® and V-TUBE™ were not uncapped by all Roche pre-analytical systems. VACUTEST® caps had rigid rubber, making it more challenging to puncture and detach the tube, which resulted in needle displacement. Both VACUCARE and V-TUBE™ were reported as user-friendly. All candidate tube analytes showed acceptable clinical performance. Conclusion: VACUCARE, VACUETTE®, VACUTEST® and V-TUBE™ are viable alternatives to BD Vacutainer®. However, based on the results obtained from the technical validation, VACUCARE was identified as the most suitable interim replacement for BD Vacutainer® during the shortage. What this study adds: This study addresses a gap in the literature on tube validation and provides valuable insights for clinical laboratories considering a replacement. It also presents an alternative approach to technical validation by utilising sigma metrics.https://ajlmonline.org/index.php/ajlm/article/view/2628blood specimen collectionspre-analytical phaserisk managementvalidation studysouth africa
spellingShingle Marizna Korf
Jody Rusch
Aye Aye Khine
Nalene Strauss
Lourens Jacobsz
Annalise E. Zemlin
Helena Vreede
Mitigating the risk of tube shortages: A blood collection tube validation study conducted in South Africa
African Journal of Laboratory Medicine
blood specimen collections
pre-analytical phase
risk management
validation study
south africa
title Mitigating the risk of tube shortages: A blood collection tube validation study conducted in South Africa
title_full Mitigating the risk of tube shortages: A blood collection tube validation study conducted in South Africa
title_fullStr Mitigating the risk of tube shortages: A blood collection tube validation study conducted in South Africa
title_full_unstemmed Mitigating the risk of tube shortages: A blood collection tube validation study conducted in South Africa
title_short Mitigating the risk of tube shortages: A blood collection tube validation study conducted in South Africa
title_sort mitigating the risk of tube shortages a blood collection tube validation study conducted in south africa
topic blood specimen collections
pre-analytical phase
risk management
validation study
south africa
url https://ajlmonline.org/index.php/ajlm/article/view/2628
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