Prevalence and types of preanalytical error in hematology laboratory of a tertiary care hospital in South India

ABSTRACT

BACKGROUND: An important component of laboratory medicine is preanalytical phase. Since laboratory report plays a major role in patient management, more importance should be given to the quality of laboratory tests.

AIM: The present study was undertaken to find the prevalence and types of preanalytical errors at a tertiary care hospital in South India.

MATERIALS AND METHODS: In this cross-sectional study, a total of 118,732 samples ([62,474 outpatient department [OPD] and 56,258 inpatient department [IPD]) were received in hematology laboratory. These samples were analyzed for preanalytical errors such as misidentification, incorrect vials, inadequate samples, clotted samples, diluted samples, and hemolyzed samples.

RESULTS: The overall prevalence of preanalytical errors found was 513 samples, which is 0.43% of the total number of samples received. The most common preanalytical error observed was inadequate samples followed by clotted samples. Overall frequencies (both OPD and IPD) of preanalytical errors such as misidentification, incorrect vials, inadequate samples, clotted samples, diluted samples, and hemolyzed samples were 0.02%, 0.05%, 0.2%, 0.12%, 0.02%, and 0.03%, respectively.

CONCLUSION: The present study concluded that incorrect phlebotomy techniques due to lack of awareness is the main reason for preanalytical errors. This can be avoided by proper communication and coordination between laboratory and wards, proper training and continuing medical education programs for laboratory and paramedical staffs, and knowledge of the intervening factors that can influence laboratory results.

Keywords

Hematology - inadequate samples - laboratory - preanalytical errors

Publikationsverlauf

Eingereicht: 13. Juni 2017

Angenommen: 06. November 2017

Artikel online veröffentlicht:
19. Februar 2020

• References

• 1 Boone DJ. Governmental perspectives on evaluating laboratory performance. Clin Chem 1993;39:1461-5.
• 2 Abdollahi A, Saffar H, Saffar H. Types and frequency of errors during different phases of testing at a clinical medical laboratory of a teaching hospital in Tehran, Iran. N Am J Med Sci 2014;6:224-8.
• 3 Aakre KM, Langlois MR, Watine J, Barth JH, Baum H, Collinson P, et al. Critical review of laboratory investigations in clinical practice guidelines: Proposals for the description of investigation. Clin Chem Lab Med 2013;51:1217-26.
• 4 Chhillar N, Khurana S, Agarwal R, Singh NK. Effect of pre-analytical errors on quality of laboratory medicine at a neuropsychiatry institute in North India. Indian J Clin Biochem 2011;26:46-9.
• 5 Narayanan S. The preanalytic phase. An important component of laboratory medicine. Am J Clin Pathol 2000;113:429-52.
• 6 Chawla R, Goswami V, Tayal D, Mallika V. Identification of the types of preanalytical errors in the clinical chemistry laboratory: 1-year study of G.B. Pant Hospital. Lab Med 2010;41:89-92.
• 7 Rana SV. No preanalytical errors in laboratory testing: A beneficial aspect for patients. Indian J Clin Biochem 2012;27:319-21.
• 8 Carraro P, Plebani M. Errors in a stat laboratory: Types and frequencies 10 years later. Clin Chem 2007;53:1338-42.
• 9 Hammerling JA. A review of medical errors in laboratory diagnostics and where we are today. Lab Med 2012;43:41-4.
• 10 HarsimranKaur VN, Selhi PK, Sood N, Singh A. Preanalytical errors in hematology laboratory- an avoidable incompetence. Iran J Pathol 2016;11:151-4.
• 11 Plebani M. Errors in clinical laboratories or errors in laboratory medicine? Clin Chem Lab Med 2006;44:750-9.
• 12 Mohammedsaleh ZM, Mohammedsaleh F. A review article of the reduce errors in medical laboratories. Glob J Health Sci 2014;7:46-51.
• 13 Kalra J. Medical errors: Impact on clinical laboratories and other critical areas. Clin Biochem 2004;37:1052-62.
• 14 Astion ML, Shojania KG, Hamill TR, Kim S, Ng VL. Classifying laboratory incident reports to identify problems that jeopardize patient safety. Am J Clin Pathol 2003;120:18-26.
• 15 Rynning M, Wentzel-Larsen T, Bolann BJ. A model for an uncertainty budget for preanalytical variables in clinical chemistry analyses. Clin Chem 2007;53:1343-8.
• 16 Da Rin G. Pre-analytical workstations: A tool for reducing laboratory errors. Clin Chim Acta 2009;404:68-74.
• 17 Ashavaid TF, Dandekar SP, Khodaiji S, Ansari MH, Singh AP. Influence of method of specimen collection on various preanalytical sample quality indicators in EDTA blood collected for cell counting. Indian J Clin Biochem 2009;24:356-60.
• 18 Favaloro JE, Funk DM, Lippi G. Preanalytical variables in coagulation testing associated with diagnostic errors in hemostasis. Lab Med 2012;43:1-10.
• 19 Upreti S, Upreti S, Bansal R, Jeelani N, Bharat V. Types and frequency of preanalytical errors in haematology lab. J Clin Diagn Res 2013;7:2491-3.
• 20 Carraro P, Servidio G, Plebani M. Hemolyzed specimens: A reason for rejection or a clinical challenge? Clin Chem 2000;46:306-7.