Effect of Pre-Analytical Errors in Laboratory Testing Facilities: the Way Forward
Abstract:
Pre-analytical
errors contribute a significant proportion of errors of all major sources of mistakes made in laboratory testing processes and are
responsible for several patient safety risks. It contributes to wrong therapeutic
interventions, irrelevant follow up laboratory investigations and diagnostic delays,
which impact negatively on the economy and laboratory effectiveness of health services. Pre-analytical phase is directly related to the procedure of specimen
collection and is mostly out of the direct control of the laboratory; further, most
pre-analytical errors are related to human factors. The aim of
the study is to
determine the nature and the occurrence of pre-analytical errors and recommendations
on possible measures to reduce these errors. A total of
300 specimens
were randomly sampled from a study population of 600 patients and analyzed for pre-analytical
errors. One hundred and eighty-four (184) samples were found unsuitable for further
processing accounting
for 1.9% of
all samples analyzed for pre-analytical errors
and sample rejection. Rejections were due to following reasons: hemolysis
21.7 % (40) wrong
tubes 19 % (35); clotted blood 17% (32); inappropriate timing of collection
15.7% (29); mislabeled
specimens 15.2% (28); insufficient specimen quantity 6.5
% (12) and lipemic
specimens 4.3% (8). The overall percentage
of rejection was 1.9% and the substantial numbers of
the rejected specimens were re-tested. Efforts aimed to reduce the rates of rejected samples can improve the
quality of laboratory-based health care response.
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