Safe Phlebotomy Practice and Adherence to Infection Prevention and Control SOPs Among Health Laboratory Practitioners in Dar es Salaam, Tanzania

Background Safe phlebotomy remains a key part of infection prevention and control (IPC) within healthcare settings, especially in laboratory units where routine handling of blood places both patients and healthcare workers at increased risk of healthcare-associated infections. Although Tanzania has established national IPC standard operating procedures (SOPs), there is still limited evidence on how well these guidelines are followed in everyday practice by health laboratory practitioners. This study therefore assessed the level of adherence to safe phlebotomy practices and explored factors associated with compliance among practitioners working in regional referral hospitals in Dar es Salaam. Methods A descriptive cross-sectional study with an observational, audit-based approach was carried out in three regional referral hospitals in Dar es Salaam: Amana, Mwananyamala, and Temeke. In total, 303 phlebotomy procedures were directly observed using a structured checklist adapted from the Tanzania National IPC Standards for Hospitals (2020). Descriptive statistics were used to summarize frequencies and percentages, while the Chi-square test was applied to examine associations between adherence and selected factors, with statistical significance set at p < 0.05. Results Overall adherence to IPC SOPs was low, with only 26(8.6%) procedures meeting the predefined compliance threshold. Adherence was consistently high for the technical steps of blood collection, including the use of sterile gloves, application of tourniquets, skin disinfection with alcohol swabs, and safe transportation of specimens, each observed in 303(100%) procedures. Correct use of single-use sampling instruments was noted in 301(99.3%) procedures, while proper patient identification was observed in 287 (94.7%). In contrast, compliance with core infection prevention measures was notably poor. Hand hygiene was performed before the procedure in only 59 cases (19.5%) and after the procedure in just 13 (4.3%). Proper cleaning of the puncture site from the center outward was observed in 41 procedures (13.5%), and only 127 (41.9%) allowed the site to dry before needle insertion. Adherence was significantly associated with professional designation (χ², p = 0.031) and the number of IPC trainings attended (χ², p = 0.020). Conclusion Adherence to safe phlebotomy practices in line with IPC SOPs was generally low, particularly for the infection prevention steps that are most critical for patient and provider safety. These findings highlight the need for regular refresher training, stronger supportive supervision, and routine observational audits to improve compliance and strengthen patient safety within laboratory settings.