Abstract
Several studies report that between 60 to 85% of laboratory errors are produced during the preanalytical phase. The objective of this study was to identify the factors at the origin of nonconformities during this phase at the Civil Hospital of Tetouan. A mixed preanalytical descriptive study realized between April and May 2014 was based on a questionnaire, an observation grid, focus groups and semi-structured interviews. The quality of preanalytical phase determines the quality and reliability of laboratory results. Indeed, 30% of the prescriptions of biologic tests are drafted by nurses and not doctors this is in the absence of an updated list of exams. The samples are taken at 84.6% by unqualified personnel and 98% without any guide or manual. For the traceability aspect, the name of the sampler is never placed on the sheet of examination, age, sex of the patient; time and nature of the sample are often not mentioned in the label vials of samples. The factors causing nonconformities laboratory tests at the civil hospital may have an impact on the quality of care. They result from a major defect of coordination between the laboratory and the services and the weak competence of the staff involved in this process. Key words: Nonconformities, quality, biological sample, preanalytical phase, hospital laboratory.
Highlights
Care services provided by health facilities are increasingly put under scrutiny by instances that require that the public has the right to quality services (Lereutre et al, 1999)
This study aims to improve the quality of laboratory tests especially during the preanalytical phase and as highlighted all managers shared responsibility between the administration and the laboratory
To reinforce safety conditions and minimize the risk of errors committed during the sampling, French law required that to the extent possible the samples sent to the laboratory must be associated with a medical tracking sheet containing all the information necessary to the performance analysis and the interpretation of results (ARF3, 1999)
Summary
Care services provided by health facilities are increasingly put under scrutiny by instances that require that the public has the right to quality services (Lereutre et al, 1999). Medical biology occupies a place increasingly important (Erikson et al, 1974). The reliability of laboratory results depends on adequate preparation which must precede the analytical phase (Togni et al, 2002). According to the French standard ISO 15189 (2007, version), the preanalytical phase represents a series of steps chronologically starting by the requirement of the analysis and by the clinician (Saadouni, 2011).
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