Caracterización de los errores asociados a la etapa preanalítica del proceso de biopsias en un hospital docente asistencial de Chile

Abstract

ObjectiveIdentify errors in the pre-analytical stage of the biopsy process. Detect critical points and blind spots in the biopsy process. Material and methodLongitudinal, prospective, descriptive study. The authors analyzed the records of 11,145 samples taken during 2012, as well as hospital log books of sample rejections and incidents. The quality of the epidemiological information in the records was evaluated (patient identification, type of sample, origin of sample, referring physician, and legibility). The data were analyzed using descriptive statistics. This research complied with all international ethical norms for this type of study. ResultsErrors occurred mainly during the pre-analytical and analytical stages. Critical points of vulnerability to error included physician order entry and daily deliveries of batches of samples. Transfers of samples between units during the pre-analytical and analytical phases were also critical points. The unit reports an error rate of 2.0% for all biopsies, according to passive observation. However, this analysis revealed an 18.95% error rate for all biopsy orders in 2012, including missing or illegible identification of the referring physician (35.93%), illegible or incorrect patient identification (26.33%), missing information on sample origin or type (13.12%), incorrect or missing clinical record number (12.15%), and incorrect or missing social identity card number (10.99%). ConclusionsOur biopsy error analysis indicates that mistakes occur most frequently during the analytical and pre-analytical stages, with 18.95% of all entries containing some type of error. It is urgent that the unit redesign aspects of the biopsy ordering process such as sample identification and epidemiological data entry. This type of error not only delays the analysis but also creates a significant risk of misdiagnosis and therefore incorrect treatment.