Analysis of preanalytical phase errors in a medical diagnostic laboratory

Abstract

Introduction: Diagnostic process may be divided into three phases: preanalytical, analytical and postanalytical. Errors with potential impact on the patient’s treatment can be made at each phase, however, most of them are preanalytical errors. Therefore, ongoing assessment of these errors is extremely important. Aim: Analysis of preanalytical errors in medical diagnostic laboratories. Materials and methods: Data collected for two years (January 2015 – December 2016) were obtained from two Wroclaw medical diagnostic laboratories: one located in a clinical hospital (clinical laboratory), second in an oncology hospital (oncology laboratory). Results: 11052 preanalytical errors were registered in the clinical laboratory. The most frequently errors recorded in 2015 were: “lack of material in tubes” (42.29%), “hemolysis/clot/lipemia” (21.46%) and “lack of test order confirmation” (10.34%). In 2016, “hemolysis/clot/lipemia” (27.84%), “wrong related material” (19.77%) and “lack of test order confirmation” (17.46%) were the biggest problems. Decrease of errors number related to the material registration was observed after introduction of a new IT system. In the oncology laboratory, 1857 preanalytical errors were registered: hemolysis (49.00%), presence of clots (24.82%) and wrong sampling (13.09%) were the most common ones. Conclusions: Appropriate evaluation of preanalytical errors allows to introduce new procedures or modernize of current ones to meet the changing needs of hospital and laboratory. Improvement in IT systems may lead to reduction in the number of errors associated with incorrect samples registration. Hemolysis and clots presence are the most common problems in the preanalytical phase.