Evaluation of Types of Pre-Analytical Errors in Clinical Chemistry Laboratory

Abstract

OBJECTIVEEvaluation of leading causes of pre-analytical errors in Clinical Biochemistry Laboratory. MATERIALS AND METHODSSamples were obtained from the OPD and indoor admitted patients and analysis of the results obtained from clinical chemistry laboratory obtained during one year of study period was done retrospectively. Data was summarised regarding the frequency of factors affecting the pre-analytical quality of results. Laboratory personnel were asked to register all the rejected samples and reasons for rejections. RESULTSOut of 62541 inpatient samples collected and screened over period, pre-analytical errors were observed in 4611 samples, which is approximately 3.75% of the total blood samples received. Insufficient volume of samples accounted for rejection of 2428 samples, which is 1.9% of total samples received during this period. Haemolysis accounted for rejection of 1.1% of samples and gross lipaemia was responsible for rejection of 0.4% samples. 0.26% of samples were rejected for having wrong/incomplete patient information. Out of 60244 samples collected total from OPD, 5552 samples were rejected for the presence of pre-analytical errors. This accounted for rejection of 4.5% of total samples received during this period. 2.7% of samples were rejected for the presence of visible haemolysis after centrifugation. Samples rejected for insufficient volume accounted to 1.9%. 0.3% of samples were rejected for having gross lipaemia. 800 samples were rejected for having wrong/incomplete patient information, which accounted for rejection of 0.8%. CONCLUSIONThe overall rate of rejection of samples is 8.52%, which is very high. Haemolysis was major reason for rejection of samples collected from OPD and error due to insufficient sample volume was found to be equal in both type of samples collected from OPD and indoor patients. KEYWORDSPre-analytical Errors, Hemolysis, Lipemia. The main aim for the diagnostic service is to get correct result on correct patient to the requesting doctor without unnecessary delays. It is also the duty of laboratory to protect patients from wrong or potentially wrong results. Typical request test report cycle consists of three phases, pre-analytical, analytical, and post-analytical phases. HOW TO CITE THIS ARTICLE:Errors arising during the sample processing are classified into pre-analytical, analytical, and post-analytical errors depending upon their source and time of presentation respectively. 1 Overall, the three processes combined are Financial or Other, Competing Interest: None. Submission 20-06-2016, Peer Review 04-08-2016, Acceptance 11-08-2016, Published 17-08-2016. Corresponding Author: Dr. Amit Ramesh Barapatre, Room No. 415, Department of Biochemistry, Fourth Floor, College Building, TNMC NAIR and B.Y.L. Ch. Hospital, Mumbai Central-08. E-mail: amit12patre@gmail.com DOI: 10.14260/jemds/2016/1076 called as 'total testing processes.' Errors can arise at any step and lead to a faulty report generation that can affect patient care like misdiagnosis, improper t...