Pre-analytical Errors in Clinical Chemistry Laboratory of a Tertiary Care Hospital (original) (raw)
Related papers
2016
Background & Objective: The errors associated with the total testing process in laboratory, affecting clinical decision making, may occur at the pre-analytical, analytical and post-analytical phase. This study is aimed at finding out the types and frequencies of errors recorded and recommending the corrective measures in pre analytical phase, which accounts for preventable errors significantly. Materials & Methods: This was a retrospective analysis of errors observed and recorded over 3 months period in clinical biochemistry laboratory at SMIMER hospital, Surat. Data analysis was done on an average of 12680 samples collected and tested. Samples included blood, urine and other fluids. Pre-analytical errors were identified and recorded subsequent to visual inspection of the samples and corresponding request forms by laboratory staff. Results: Pre-analytical errors were classified as A) inappropriate form (28.24%), B) inappropriate sample (3.52%), C) inappropriate transport (22.16%) and D) inappropriate centrifugation (7.29%). For category A, high error rate for date and time of sample collection (99.97%), provisional diagnosis (99.92%) and physician's detail (100%) were observed. For category B, error rate for insufficient sample volume was 26.38%. For category C, error rate for date and time of sample receipt was 100%. Pre-analytical error rate was highest for samples received from outpatient department (18.37%) and for urine sample (18.61%) comparatively. Conclusion: Pre-examination errors were high at this study location. Measures aimed at reducing the same and exposure to accreditation are recommended for improved laboratory quality output.
Identifying Errors Involving Clinical Laboratory: A 1 Year Study
International Journal of Health Sciences and Research, 2014
OBJECTIVE: It is a known fact that in modern day, laboratory diagnosis is the cornerstone of health care system. It is seen that pre and post analytical phases in a testing cycle contribute majority of the laboratory errors. This study was conducted to recognize the errors that occurs in the three phases of the testing cycle and for improvement in the areas where required. METHODS: The present study was conducted during the period 2012-13 in the central laboratory in M.G.M. Hospital and Medical College. During a 12 month period 97,618 samples were monitored for major pre analytical, analytical and post analytical errors RESULTS: From the study it was documented that total errors were 14,149 of which pre-analytical were 9,867 (69.7%), analytical were 751 (5.3%) and post-analytical were 3,531 (25%). CONCLUSION: Our study showed that most of the errors pre-analytical either during sampling or preparation for analysis. The continuous improvement of the phases of testing cycle seems to b...
Evaluation of analytical errors in a clinical chemistry laboratory: A 3 year experience
Annals of Medical and Health Sciences Research, 2015
Background: Proficient laboratory service is the cornerstone of modern healthcare systems and has an impact on over 70% of medical decisions on admission, discharge, and medications. In recent years, there is an increasing awareness of the importance of errors in laboratory practice and their possible negative impact on patient outcomes. Aim: We retrospectively analyzed data spanning a period of 3 years on analytical errors observed in our laboratory. The data covered errors over the whole testing cycle including pre-, intra-, and post-analytical phases and discussed strategies pertinent to our settings to minimize their occurrence. Materials and Methods: We described the occurrence of pre-analytical, analytical and post-analytical errors observed at the Komfo Anokye Teaching Hospital clinical biochemistry laboratory during a 3-year period from January, 2010 to December, 2012. Data were analyzed with Graph Pad Prism 5(GraphPad Software Inc. CA USA). Results: A total of 589,510 tests was performed on 188,503 outpatients and hospitalized patients. The overall error rate for the 3 years was 4.7% (27,520/58,950). Pre-analytical, analytical and post-analytical errors contributed 3.7% (2210/58,950), 0.1% (108/58,950), and 0.9% (512/58,950), respectively. The number of tests reduced significantly over the 3-year period, but this did not correspond with a reduction in the overall error rate (P = 0.90) along with the years. Conclusion: Analytical errors are embedded within our total process setup especially pre-analytical and post-analytical phases. Strategic measures including quality assessment programs for staff involved in pre-analytical processes should be intensified.
Determination of errors that compromise the quality of laboratory service in a tertiary hospital
Asian Journal of Medical Sciences, 2017
Background: Clinical Laboratory testing is a highly complex process that entails numerous procedures. Although it has been known that laboratory testing services are safe, it is increasingly becoming a common knowledge that they are not that safe. Studies have indicated that there are a number of errors that occur due to laboratory testing processes. These errors may not be realized easily during the testing process, but they make significant impact on the results given. Aims and Objective: To determine the levels of pre-analytical, analytical, and post analytical errors found in the analysis of Clinical chemistry Laboratory specimen. Materials and Methods: A prospective and Descriptive study was carried out at Clinical Chemistry a total of 346 request forms, specimens/samples and dispatched results were scrutinized and errors documented as per the different variables in the different phases, over a period of three months and the findings were analyzed. Results: Results of the study showed that Preanalytical errors were most common with a frequency of 148(42.8%), followed by analytical errors 114 (32.9%) and post analytical errors 84 (24.3%), respectively. Conclusions: The study concludes that pre-analytical, analytical, and post analytical errors are errors that compromise the quality of laboratory service delivery, which impacts on the patient management and diagnosis. Clinical laboratory errors can be minimized if due diligence and professionalism is adhered in the laboratory.
Assessment of laboratory errors and best laboratory practices
International Journal of Bioassays, 2016
Laboratory error is defined by ISO 22367 as “Failure of planned actions to be completed as intended or use a wrong plan to achieve an aim”. Lundeberg in 1981 outlined the concept of Total Testing Process (TTP) and Plebani elaborated it further and classified the whole testing process into five phases of Pre-Pre Analytic, Pre Analytic, Analytic, Post Analytic and Post - Post Analytic. The errors have to be identified and resolved in each phase of the process. The medical laboratories have to run Internal and External Quality Control programs and abide by the guidelines of ISO 15189 in order to be accredited by bodies like JCI, CAP or NABL. Active communication and regular interaction between the clinicians and the laboratory is recommended during Pre Analytic and Post Analytic phases of TTP in order to achieve the target of Best Laboratory Practices.
Management of errors in a clinical laboratory
Clinical laboratories focus their attention on quality control methods. However, such quality control cannot be assured by merely focusing on analytical aspects as both pre-analytical and post-analytical phases must be considered as well. This article analyses the causes of errors occurring in clinical laboratories by evaluating literature data and statistics from the " AMES " poly-diagnostic centre in Naples.
International Journal of Emerging Trends in Health Sciences, 2023
The clinical laboratory is an important stakeholder in the patient management process with a direct impact on patient care by providing evidence and data for diagnosis and treatment. Identifying reliable quality indicators in clinical laboratories is an important step in enabling users to measure the quality of laboratory service. Any error in the pre-analytical process affects other processes and jeopardizes patient safety. This study aimed to examine the number of specimen rejections in clinical laboratories, their reasons, and their range according to the departments. The study was a descriptive retrospective study. The population of the study consisted of samples rejected from the Biochemistry Laboratory of a teaching and research hospital in 2021. Data were analyzed using percentage and frequency analysis. The study recommends that practices to minimize errors in the pre-analytical process should be carried out urgently by the management and a training plan for sample collection should established.
International Journal of Bioassays, 2014
A prospective observational study was done in the Central Clinical Laboratory of Gauhati Medical College & Hospital for a period of 2 months from 1 st March to 30 th April 2014. The objective of the study was to evaluate the pre-analytical phase of laboratory testing in a Clinical Biochemistry Laboratory to detect the different errors which occurred in the preanalytical phase and calculate their percentage and to determine in which step the error occurred so that corrective measures can be formulated to avoid such errors. All the samples and their accompanying laboratory request forms were screened for pre-analytical errors and the daily errors and their types recorded in Problem Notification Logbook. The data collected was analyzed and the entire process of sample collection and transport was evaluated to formulate corrective measures to prevent these errors from occurring. The total number of samples received in 2 months was 23,680. Out of this OPD samples were 11,414 and Indoor s...
Quality-Improvement Measures as Effective Ways of Preventing Laboratory Errors
Laboratory Medicine, 2014
Laboratory error is defined as any defect from ordering tests to reporting and interpretation of results. Laboratory errors have a reported frequency of 0.012-0.6% of all test results which in turn has huge impact on diagnosis and patient management as 60-70% of all diagnosis are made on the basis of laboratory tests. Total testing process in the laboratory is a cyclical process divided into three phases: preanalytical, analytical and postanalytical. First, preanalytical phase in which requirement for a test is determined, the test is ordered and the patient is identified. It is followed by specimen collection and transport to the laboratory. The specimen is prepared and tested in the analytical phase. During the postanalytical phase, the results are reported to the individual who ordered the test and any action or intervention is undertaken. Initially, the policies and procedures developed by the laboratory were more concerned on analytical phase to reduce errors during laboratory testing and emphasis was in ensuring proper calibration and testing. The last few decades have seen a significant decrease in the rates of analytical errors in clinical laboratories. Currently, available evidences demonstrate that the pre-and postanalytical steps are more error prone.