Study of pre analytical errors in clinical biochemistry laboratory in rural area of Punjab

Abstract

Introduction: The pre analytical phase is an important component of laboratory medicine. It includes the time from the order of test by the clinician until the sample is ready for analysis – it can account up to 70% of errors during the total diagnostic process. The major 5 key components for the establishment of quality and reliability in the laboratory diagnostics include (a) Quality laboratory process (QLPs), (b) Quality control(QC), (c) Quality Assurance/Assessment (QA), (d) Quality Improvement (QI) and (e) Quality policy(QP). Objectives: 1. To stratify the pre-analytical errors documented during pre analytical testing process; 2. To formulate the possible corrective measures to be taken to minimise such errors. Materials and Methods: A prospective study was done for a period of 6 months from 1st august 2019 to 31st Jan 2020 in Clinical Biochemistry laboratory of PGIMER satellite centre, Sangrur. All types of pre-analytical errors were Recorded. In our study, total blood specimens received during Aug 2019 to Jan 2020 were 2980. Out of which 284 specimens were sorted with pre analytical errors. Results: These 284 specimens were categorised as follows: Improper request form (n= 24); improper labelling (n=39); improper tube collection (n=51); insufficient sample n=48); in-vitro haemolysis (n=66), sample not received(SNR) (n=56). Conclusion: Pre-analytical errors are not inevitable and can be avoided with a diligent application of proper quality control, proper education of phlebotomist about the errors and effective collection systems to improve the total quality management of laboratory so as to ensure total quality patient care.