A study of pre-analytical errors in a hospital based clinical biochemistry laboratory and formulation of measures for correction

Abstract

A prospective observational study was done in the Central Clinical Laboratory of Gauhati Medical College & Hospital for a period of 2 months from 1 st March to 30 th April 2014. The objective of the study was to evaluate the pre-analytical phase of laboratory testing in a Clinical Biochemistry Laboratory to detect the different errors which occurred in the preanalytical phase and calculate their percentage and to determine in which step the error occurred so that corrective measures can be formulated to avoid such errors. All the samples and their accompanying laboratory request forms were screened for pre-analytical errors and the daily errors and their types recorded in Problem Notification Logbook. The data collected was analyzed and the entire process of sample collection and transport was evaluated to formulate corrective measures to prevent these errors from occurring. The total number of samples received in 2 months was 23,680. Out of this OPD samples were 11,414 and Indoor samples were 12,266.Of the 12,266 laboratory request forms which were screened 12,106, forms were incomplete i.e. only 160 forms carried all the required information. Out of the total 23,680 sample tubes screened preanalytical errors were observed in 6.61% of Indoor samples and 3.69% of OPD samples. Hemolysed sample was the most commonly observed preanalytical error both in OPD and Indoor samples. Hemolysis was observed in 4.25% of Indoor samples and in 3.55% of OPD samples. Insufficient sample volume was observed in 1.74% of Indoor and .026% of OPD samples. Preanalytical error was observed in 5.20% of samples during the study period. Of this 3.91% of samples received were hemolysed and were rejected .Corrective measures have to be taken to reduce the percentage of rejected samples.