Challenges in Preanalytical Phase of Laboratory Medicine: Rate of Blood Sample Nonconformity in a Tertiary Care Hospital

Nusrat Alavi, Sana Haseeb Khan, Asma Saadia, Tahir Naeem, Nusrat Alavi, Sana Haseeb Khan, Asma Saadia, Tahir Naeem

Abstract

Objective: To evaluate the major causes of preanalytical errors in medical laboratory of a tertiary care hospital.

Methods: It was a retrospective study in which we analyzed the sample rejection data of hematology and chemical pathology sections from January to December 2018. Number of rejected samples, reason for rejection and type of test ordered on monthly basis were recorded on a platform.

Results: A total of 113,817 samples were received during the study period. Preanalytical errors were found in 1,688 samples, which constitute approximately 1.48% of the total number of samples received.

Conclusion: Our study highlights the magnitude of preanalytical errors in our setup. Preanalytical errors can lead to loss of patient trust in diagnostic services, can dent the laboratory's reputation, and lead to an increase in the overall operating expenses, both for laboratories as well as the hospitals. Compliance with good laboratory practices can significantly reduce the frequency of pre analytical errors.

Keywords: clinical laboratory blood specimen collection; medical errors; phlebotomy; specimen handling.

Copyright © 2020 International Federation of Clinical Chemistry and Laboratory Medicine (IFCC). All rights reserved.

Figures

Figure 1
Figure 1
Preanalytical errors per month

References

    1. Saurav Patra M, Mukherjee B, Das AK. Preanalytical errors in the clinical laboratory and how to minimize them. Int J Bioassays 2013;02:551-553.
    1. Lima-Oliveira G, Volanski W, Lippi G, Picheth G, Guidi GC. Preanalytical phase management: a review of the procedures from patient preparation to laboratory analysis. Scand J Clin Lab Invest 2017;77:153–163.
    1. Lippi G, Lima-Oliveira G, Brocco G, Bassi A, Salvagno GL. Estimating the intra- and inter-individual imprecision of manual pipetting. Clin Chem Lab Med 2017;55:962–966.
    1. Simundic AM, Lippi G. Preanalytical phase-a continuous challenge for laboratory professionals. Biochem Med 2012;22:145-149.
    1. Lippi G, Plebani M, Simundic AM. Quality in laboratory diagnostics: From theory to practice. Biochem Med 2010;20:126–130.
    1. Hammerling JA. A Review of Medical Errors in Laboratory Diagnostics and Where We Are Today. Lab Med 2012;43:41–44.
    1. Almatrafi AA. Preanalytical Errors: A Major Issue in Medical Laboratory. Acta Sci Med Sci 2019;3:93-95.
    1. Giavarina D, Lippi G. Blood venous sample collection: Recommendations overview and a checklist to improve quality. Clin Biochem 2017;50:568-573.
    1. Lima-Oliveira G, Lippi G, Salvagno GL, Picheth G, Guidi GC. Laboratory Diagnostics and Quality of Blood Collection. J Med Biochem 2015;34:288–294.
    1. Lima-Oliveira G, Cesare Guidi G, Guimaraes AVP, Abol Correa J, Lippi G. Preanalytical Nonconformity Management Regarding Primary Tube Mixing in Brazil. J Med Biochem 2017;36:39–43.
    1. Chawla R, Goswami B, Tayal D, Mallika V. Identification of the types of preanalytical errors in the clinical chemistry laboratory: 1 year study at GB Pant hospital. Lab Med 2010;41:89–92.
    1. Gimenez-Marin A, Rivas-Ruiz F, Perez-Hidalgo Mdel M, Molina-Mendoza P. Preanalytical errors management in the clinical laboratory: a five year study. Biochem Med 2014;24:248-257.
    1. Najat D. Prevalence of Preanalytical Errors in Clinical Chemistry Diagnostic Labs in Sulaimani City of Iraqi Kurdistan. PLoS ONE 2017;12:e0170211.
    1. Simundic AM, Bölenius K, Cadamuro J, Church S, Cornes MP, van Dongen-Lases EC, Eker P, Erdeljanovic T, Grankvist K, Guimaraes JT, Hoke R, Ibarz M, Ivanov H, Kovalevskaya S, Kristensen GBB, Lima-Oliveira G, Lippi G, von Meyer A, Nybo M, De la Salle B, Seipelt C, Sumarac Z, Vermeersch P, Working Group for Preanalytical Phase (WG-PRE), of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and Latin American Working Group for Preanalytical Phase (WG-PRE-LATAM) of the Latin America Confederation of Clinical Biochemistry (COLABIOCLI) Joint EFLM-COLABIOCLI Recommendation for venous blood sampling. Clin Chem Lab Med 2018;56:2015-2038.
    1. Arul P, Pushparaj M, Pandian K, Chennimalai L, Rajendran K, Selvaraj E, Masilamani S. Prevelence and types of preanalytical error in hematology laboratory of a tertiary care hospital in South India. J Lab Physicians 2018;10:237-240.
    1. Lippi G, Bassi A, Brocco G, Montagnana M, Salvagno GL, Guidi GC. Preanalytic error tracking in a laboratory medicine department: results of a 1-year experience. Clin Chem 2006;52:1442-1443.
    1. Green SF. The cost of poor blood specimen quality and errors in preanalytical processes. Clin Biochem 2013;46:1175-1179.
    1. Lima-Oliveira G, Lippi G, Salvagno GL, Montagnana M, Picheth G, Guidi GC. The effective reduction of tourniquet application time after minor modification of the CLSI H03-A6 blood collection procedure. Biochem Med 2013;23:308–315.
    1. Lima-Oliveira G, Lippi G, Salvagno GL, Montagnana M, Picheth G, Guidi GC. Impact of the phlebotomy training based on CLSI/NCCLS H03-a6-procedures for the collection of diagnostic blood specimens by venipuncture. Biochem Med 2012;22:342–351.

Source: PubMed

3
Suscribir