Abstract
Background: In the laboratory, errors can occur at any stage of sample processing; pre-analytical, analytical, and post-analytical. Since the pre-analytical phase is the most common source of laboratory errors, the goal of this study is to identify the types and frequency of pre-analytical errors in the hematology laboratory.Materials and Methods: This is a cross-sectional descriptive study done at Nepal Medical College Teaching hospital for a duration of nine months (January 2020 to September 2020). All blood samples received at the hematology laboratory were included whereas biochemistry and special tests blood samples were excluded. Samples were checked for misidentification (incorrectly labeled vials/vials without labels/incorrectly filled forms), incorrect samples (wrong choice of vials), clotted samples, inadequate samples, diluted samples, hemolyzed samples. The errors that occurred in these samples (both inpatient and outpatient) were noted down and measures were taken accordingly before analyzing the sample.Results: The total number of samples received was 15,337. Pre-analytical errors were seen in 857 samples (5.5%). Inadequate samples (25%) were the most common error followed by incorrect samples (20%), hemolyzed samples (20%), misidentification (14%), clotted samples (12%), and diluted samples (9%). Complete blood count test was most affected. Samples from the inpatient department were most affected.Conclusions: The preanalytical error rate in the hematology unit was 5.5% with an inadequate sample being the commonest error. Most of the errors were seen in the test requested for a complete blood count. Samples from the inpatient department showed the most errors.
Highlights
The clinical laboratory is a rapidly changing field that has a very strong impact directly on patient’s treatment
All blood samples received at the hematology unit of the laboratory during the study period were included whereas biochemistry and special tests blood samples were excluded
The total number of samples received in the hematology unit was 15,337 samples in nine months duration
Summary
The clinical laboratory is a rapidly changing field that has a very strong impact directly on patient’s treatment. Lack of standardized procedures for sample collection accounts for most of the errors encountered within the total testing process. They can have clinical consequences as well as a significant impact on patient care, especially those related to specialized tests as these are often considered as "diagnostic".3. Errors can occur at any stage of sample processing; pre-analytical, analytical, and post-analytical stages. The receipt and processing of specimens are one of the main steps in the pre-analytical stage Errors in this stage could be due to mislabeling, incorrect test entry, and entering the wrong location. Errors can occur at any stage of sample processing; pre-analytical, analytical, and post-analytical. Since the pre-analytical phase is the most common source of laboratory errors, the goal of this study is to identify the types and frequency of pre-analytical errors in the hematology laboratory
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