Abstract
Introduction: The pre-analytical phase involves most of the errors of clinical analysis laboratories. Information characterizing the occurrence of these errors can be useful to provide prevention and reduction strategies. Objective: The aim of this study was to identify the main errors in the pre-analytical phase of a private laboratory in the city of Maringa-PR, and their occurrence rate. Materials and methods: Data were collected from sample recollection orders from June 2013 to May 2015. A total of 707,449 exams collections were registered, and 1,274 (0.18%) of these had ordered a new collection based on some criteria adopted by the laboratory. Conclusion: The pre-analytical phase represented 70.8% of the orders for new collection. According to the reports from the Quality Control Database, the most frequent reason of recollection in the preanalytical phase was insufficient sample volume (58.54%), followed by clotted sample (19.29%), hemolyzed sample (9.43%), incorrect labeling of sample (8.21%), lipemic sample (3%) and improper sample (1.56%). Although the results of nonconformity forms presented different records, both clearly point to problems in collection and patient registration sector, sustaining that the main problems of clinical laboratories arise from the failure in quality specifications for pre-analytical phase.
Highlights
The pre-analytical phase involves most of the errors of clinical analysis laboratories
These criteria were selected after consecutive meetings with the professionals involved in the quality management of the laboratory, including: clotted samples for hematology and coagulation tests; hemolysed or lipemics samples; ulabeled or incorrectly labeled samples; improper specimen; insufficient specimen sample; inconclusive results and confirmation of results
The goal set by the Laboratory Quality Management involved in this research was 0.25% maximum sample recollection rate, this threshold was based on personnel and processes costs
Summary
The pre-analytical phase involves most of the errors of clinical analysis laboratories. Automation and computerization have made the service offered more productive, efficient and systematic, outlining a new profile of professionals involved in the process as well as a routine that follows protocols and procedures with the hopes of reduce and avoid errors[1,2,3,4,5,6,7,8,9,10,11] Despite all these improvements and the abundant scientific literature on improving the quality of the services offered by Clinical Laboratories, errors are still present; detecting these erros will lead to data rejection and the collection of new biological samples. The post-analytical phase is immediately after the acquisition of the tests results and ends with the release of the report(3, 4, 6, 8-10, . 13-18)
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