Online ISSN: 2515-8260

Keywords : Pre-analytical errors


Identification of preanalytical errors in clinical biochemistry Laboratory in a pediatric tertiary care centre: A Prospective Analytical Study

Priyanka Prasad, Rakesh Kumar, Binod Kumar Singh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10547-10552

Background: Pre-analytical errors account for up to 70% of all mistakes made in
laboratory diagnostics, most of which arise from problems in patient preparation,
sample collection, transportation, and preparation for analysis and storage. Preanalytical
errors influence the total error thus hindering TQM in laboratory,
consequently decreasing the accuracy and reliability of the results generated. The
frequencies of PAE and sample rejection rates in pediatric clinics are not yet fully
understood compared to PAE in adult departments. Such pre-analytical errors (PAE)
can affect children’s safety due to delayed clinical decision-making support or
discomfort related to repeat blood sampling. This study was conducted with the aim to
determine nature and frequency of the occurrence of pre-analytical errorsin pediatric
patients.
Material and Methods: This prospective analytical study was designed to evaluate the
pre-analytical errors observed in a total of 2971 out-patient and inpatient samples
received from pediatric patients. Samples received for routine clinical chemistry
analysis were screened for pre-analytical errors. Samples received for other
investigations were excluded. We recorded all nonconformities and errors occurring
over a 3-month period and corrective measures were suggested to minimize them.
Laboratory personnel were asked to register rejections, and pre-analytical causes for
rejection of ward as well as out-patient samples collected in the laboratory. Types of
inappropriateness were evaluated as follows: hemolysed, blood collection in wrong
tubes, clotted blood, inappropriate timing of collection, improperly labeled samples,
insufficient volume of specimen and old samples.
Results: A total of 2971 samples from the outpatient pediatric department and in-house
pediatric patients were received by our clinical biochemistry laboratory during the
period from March 2022 to May 2022. Out of these 95 samples were found unsuitable
for further processing. This accounted for 3.2% of all samples collected in the
laboratory and pre-analytical errors were responsible for these samples to be rejected
over a period of 3 months. Rejections arose as a result of the following reasons: 1.02%
were rejected due to hemolysis; 0.67% were blood collected in wrong tubes; 0.61% were
clotted blood; 0.29% had inappropriate timing of collection; 0.26%were mislabeled
samples; 0.21% had insufficient sample quantity and 0.14% were old samples.

STUDY OF THE ERRORS IN HEMATOLOGY LABORATORY IN A TERTIARY CARE HOSPITAL

Shamaila Aadil

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 1366-1381

Background: Error in any laboratory starts from the moment any investigation is
being planned till it is interpreted and clinical judgment is made. Entire process is difficult
to perform without error.
Aim : Study of the Errors in hematology laboratory in a tertiary care hospital.
TeerthankerMahaveer Medical college and Research center (Moradabad). Purpose: To
investigate for errors and causes of errors related to different hematological tests in
hematology laboratory.
Methodology: In this observational study, a total of 304,358 tests (95,991 outpatient
department [OPD] and 208,367 inpatient department [IPD]) were received in haematology
laboratory. These errors were further categorized as Pre-analytical, Analytical and Postanalytical.
Result: The Pre-analytical errors constituted maximum number of errors i.e.in 501samples
(94.7% of total errors) which constituted major chunk of errors which is close to 0.16%,
which was followed by post analytical errors which was found in 17cases (3.21% of total
errors) with frequency of 0.0036% ;Analytical errors were detected in least number of
cases i.e.11reports (2.07% of total errors)
Conclusion: Errors in hematology laboratory which is classified as Pre-analytical,
analytical, and post-analytical errors remain the biggest limitation to laboratory service
and it thus has impact on healthcare management and cost involved. Majority of reasons
involved behind analytical errors is within the scope of laboratory and thus can be reduced
to a great extent by training of laboratory staff, participation in quality system and regular
monitoring of equipment’s. We found analytical error to be close to 2% most of which were
related to auto clumps which can be resolved by incubation at body temperature most of
the time as these are cold auto agglutinins which poses analytical problem, especially in
winters. We found Post analytical error also to be insignificant (3.2%), most of which was
due to wrong entry of results, such errors can also be avoided and minimized by close and
frequent monitoring of laboratory reports.