Wrong matching between sample and laboratory s files 2. The pre analytical phase of the total laboratory testing process is where the majority of laboratory errors occur. As with the preanalytic phase, the errors of the postanalytical can occur either inside or outside of the laboratory. Often these papers play a zerosum game, emphasizing pre and postanalytical quality while diminishing the importance of analytical quality. It seems that people want to believe that analytical errors arent as frequent as the pre analytical and post analytical errors. These include inappropriate tests that have been ordered, improper sample collection, transport delays, and illegible handwriting on requisition slips. In this lesson, sources of errors for the pre analytic and postanalytic phases of the total testing process are discussed, along with possible solutions. Preanalytical errors management in the clinical laboratory. Preanalytical errors are quite frequent in the area of pointofcare testing poct. A presentation on preanalytical errors presented by. Jun 15, 2014 indeed, measuring and managing pre analytical critical errors continues to be the major challenge facing clinical laboratories 7,8,22,23, and the main difficulty in this respect lies in achieving an effective, systematic design to ensure that safe procedures and processes are adopted, accompanied by all necessary corrective procedures 3,24. Indeed, measuring and managing preanalytical critical errors continues to be the major challenge facing clinical laboratories 7,8,22,23, and the main difficulty in this respect lies in achieving an effective, systematic design to ensure that safe procedures and processes are adopted, accompanied by all necessary corrective procedures 3,24. Reference rangesintervals most tests are performed to con. Preanalytical phase is most important in testing process and involves variables that are not under the control of the laboratory.
The preanalytical before analysis or preexamination phase of the testing process begins for the laboratory when a test is ordered and ends when testing begins. Preanalytical errors related to venous blood sample. Most failures or mistakes occur in the pre analytical or post analytical process. Nonlab personnel were responsible for 29% of the mistakes. Distribution of errors within the total testing process. This study describes quality indicators for the preanalytical process, grouping errors according to patient risk as critical or. Preanalytical errors in laboratory their consequences. The present study was undertaken with an objective to evaluate different types and frequencies of pre analytical and post analytical errors in hematology laboratory of a tertiary care hospital. Quality indicators to detect preanalytical errors in laboratory testing. Errors in clinical laboratories or errors in laboratory medicine. In larger laboratories, it is common to see a disconnection between different areas of. Pre analytical laboratory errors free download as powerpoint presentation. The pre and post analytical phases of the process account for 93% of errors. Research degrees subcommittee and as well as the approval documents from the.
The diagnostic consequences depend on the magnitude of the preanalytical. Preanalytical laboratory errors vein tissue biology. The identification of reliable quality indicators qis is a crucial step in enabling users to quantify the quality of laboratory services. The current lack of attention to extra laboratory factors is in stark contrast to the body of evidence pointing to the multitude of errors that continue to occur, particularly in the pre analytical phase. A tool for reducing laboratory errors giorgio da rin.
Preanalytical specimen collection, request forms, processing analytical. Beyond the initial input that assist the project planners in the design of the sampling plan, it is. Currently, 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. Laboratory errors total testing process information technology preanalytical.
Post analytical errors like typographical errors can be avoided with laboratory interface systems and hospital information system in vogue. Oct 12, 2017 pre and post analytical errors by rrof. A fiveyear study article pdf available in biochemia medica 242. Reducing preanalytical errors whitehat communications. Through this video she explained about analytical errors in clinical laboratory which affects patients safety. As with the pre analytic phase, the errors of the post analytical can occur either inside or outside of the laboratory. In this lesson, sources of errors for the preanalytic and postanalytic phases of the total testing process are discussed, along with possible solutions. Identification and reduction of preanalytical errors in clinical. Most failures or mistakes occur in the preanalytical or postanalytical process. Are we getting better at the preanalytical phase or just. Reasons of pre analytical errors it is found that there are some major reasons that cause errors in pre analytical phase of laboratory testing like unawareness among healthcare professionals, do not follow the guidelines, carelessness during the sample collection, handling, storage and transportation. The classic paradigm for a wider view of errors is the total testing process ttp.
The goal of the journal of laboratory and precision medicine is to provide a valuable platform for exchanging information in the multidisciplinary arena of precision laboratory medicine data. Management of the quality in the preanalytical phase. Preanalytical issues in the haemostasis laboratory. Advances in instrument technology and automation have simplified tasks in laboratory diagnostics reducing errors during analysis thereby improving the quality of test results. Often these papers play a zerosum game, emphasizing pre and post analytical quality while diminishing the importance of analytical quality. Indeed, the dissemination of recommendations and guidelines on the best practices for the preanalytical phase, along with the establishment of many international and national working groups on this topic e. Although, most of the laboratory quality improvement efforts once focused on improving the analytic process, findings reported in the literature showed that pre analytical factors call for an equally thorough consideration and investigation, and indicated that laboratories should implement a series of effective interventional measures to reduce pre. Preanalytical errors, quality indicators, laboratory errors, patient safety. Pre analytical errors can occur at the time of patient assessment, test order entry, request completion, patient identification, specimen collection, specimen transport, or specimen receipt in the laboratory. Preanalytical laboratory errors free download as powerpoint presentation. Beginning with test ordering and ending with result reporting, ttp encompasses the preanalytical, analytical, and postanalytical phases of testing figure 1. Review of medical errors in laboratory diagnostics and where. Preanalytical variation includes all the steps that occur from test ordering until right before. Study has shown that errors occur much more frequently in the prepreanalytic than the preanalytic phase 9.
Most errors affecting laboratory test results occur in the pre analytical phase 4668. The pre analytic testing phase occurs first in the laboratory process. Although, most of the laboratory quality improvement efforts once focused on improving the analytic process, findings reported in the literature showed that preanalytical factors call for an equally thorough consideration and investigation, and indicated that laboratories should implement a series of effective interventional measures to reduce pre. Important errors can occur during the pre analytic phase with specimen handling and identification. Quality indicators to detect preanalytical errors in. Preanalytical steps, the major source of mistakes in laboratory diagnostics, arise during patient preparation, sample collection, sample transportation, sample. Important errors can occur during the preanalytic phase with specimen handling and identification. Apr 29, 2015 a recent investigation performed by the working group for preanalytical phase wg pre of the european federation for clinical chemistry and laboratory medicine eflm has shown that blood sampling in europe is performed by different professions with significantly different levels of education, background, competence and skills. Preanalytical variables and factors that interfere with the. Quality assurance system the activity of a laboratory to ensure the reliability of test results, to increase accuracy, reproducibility and laboratory to laboratory comparability. Jan 24, 2018 through this video she explained about analytical errors in clinical laboratory which affects patients safety. Keywords preanalytical errors, quality indicators, laboratory errors, patient safety accepted. Educational commentary preventing preanalytic laboratory errors cont. Laboratory errors can be defined as any defect from ordering tests to reporting results and appropriately interpreting and reacting on these.
The present study was undertaken with an objective to evaluate different types and frequencies of preanalytical and post analytical errors in hematology laboratory of a tertiary care hospital. Pdf preanalytical errors management in the clinical laboratory. Preanalytical laboratory errors can arise throughout the preanalytical phase, because this phase comprises a lot of manual activities and accounts for most of the errors correspondence. Preanalytical errors related to venous blood sample collection and handling preanalytical errors related to venous blood sample collection and handling. Received 9 march 2009 accepted 10 march 2009 available online 18 march 2009 keywords. Effect of preanalytical errors on quality of laboratory. Pre analytical variableserrors are often unknown to testing personnel and the clinicians. Objectives list the three different phases of the testing process and. The quantity of errors in the post analytical phase makes it the second most affected in the ttp as previously stated. Figure 1 major sources of preanalytical variability. Chapter 9 analytical quality assurance this chapter was prepared by r. Several studies have documented that most of the errors in the clinical laboratory occur in the pre analytical phase accounting up to 80% 2,4,6, 8, 9. Preanalytical, analytical, and postanalytical phases of. Useful tips to avoid preanalytical errors in blood gas.
Preanalytical errors and their impact on tests in clinical. Preanalytical variables and factors that interfere with. Wrong copy of results from th e analyzer s report to the laboratory report in cases of manual transfer 3. Postanalytical phase quality assurance for laboratory. Diagnostic errors and laboratory medicine causes and. The quantity of errors in the postanalytical phase makes it the second most affected in the ttp as previously stated. Study of preanalytical and postanalytical errors in hematology. Educational commentary preventing preanalytic laboratory errors learning objectives upon completion of this exercise, you should be able to. It is primarily a management system, and as such is analyteindependent, because it deals with the overall running of the laboratory rather than focusing on individual analyses.
Pre analytical errors damage an institutions reputation, diminish confidence in healthcare services, and contribute to a significant increase in the total operating costs, both for the hospital and laboratory. Preanalytical variableserrors are often unknown to testing personnel and the clinicians. To be properly evaluated, test results typically need to be compared with results expected of healthy individuals. Study of preanalytical and postanalytical errors in. We will concentrate on the preanalytical errors which include specimen type.
Department of clinical laboratories quality improvement plan for al amiri clinical laboratories department 2018 goal i reduction of rejected specimens due to preanalytical errors objective 1 reduce the percentage of clotted specimens in the haematology unit from the. Order entry errors and misidentification of either the patient or the specimen comprise most of the. However studies show that most laboratory errors occur in the preanalytical phase. Numerous factors associated with this phase of the testing process, if not properly addressed, can lead to errors that can compromise specimen quality, jeopardize the health and safety of the. Delay in delivering the results to the physicians, clinics or patients 4.
Prevalence of preanalytical errors in clinical chemistry. Pdf preanalytical errors management in the clinical. It seems that people want to believe that analytical errors arent as frequent as the preanalytical and postanalytical errors. In view of the paucity of studies examining preanalytical errors, we examined a total of 15 request forms received at our laboratory. Laboratory errors total testing process information technology pre analytical. Useful tips to avoid preanalytical errors in blood gas testing. Phlebotomy preanalytical errors flashcards quizlet. Prevention of such errors requires a coordinated interdepartmental group approach.
In the pre analytical phase, the important errors are as follows a. Reliability of data for a water quality monitoring programme depends on strict adherence to a wide range of operating. The preanalytic testing phase occurs first in the laboratory process. The aim is to highlight the multifactorial human dependent erroneous stage that affects the biochemical routine test results, which can be easily prevented with awareness and laboratory staff education. Pre analytical variation includes all the steps that occur from test ordering until right before. Preanalytical specimen collection, request forms, processing analytical procedure, reagents, equipment, environment postanalytical results, interpretation, transcription, reports. This phase may include specimen handling issues that occur even prior to the time the specimen is received in the laboratory. Briggs this chapter outlines the various techniques that may be employed in analytical quality assurance aqa, and the reasons why they should be used. First of all, poct testing is usually performed by clinical staff i. Currently, preanalytical 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. Identification of the types of preanalytical errors in the. This study was undertaken to evaluate the types of pre analytical errors in our tertiary care set up 1, 2.
Learn vocabulary, terms, and more with flashcards, games, and other study tools. The current lack of attention to extralaboratory factors is in stark contrast to the body of evidence pointing to the multitude of errors that continue to occur, particularly in the preanalytical phase. However, pre analytical errors remain a challenge for practicing pathologists. Quality assurance system the activity of a laboratory to ensure the reliability of test results, to increase accuracy.