Determination of errors that compromise the quality of laboratory service in a tertiary hospital

Abstract

Background:Clinical Laboratory testing is a highly complex process that entails numerous procedures. Although it has been known that laboratory testing services are safe, it is increasingly becoming a common knowledge that they are not that safe. Studies have indicated that there are a number of errors that occur due to laboratory testing processes. These errors may not be realized easily during the testing process, but they make significant impact on the results given. Aims and Objective: To determine the levels of pre-analytical, analytical, and post analytical errors found in the analysis of Clinical chemistry Laboratory specimen. Materials and Methods: A prospective and Descriptive study was carried out at Clinical Chemistry a total of 346 request forms, specimens/samples and dispatched results were scrutinized and errors documented as per the different variables in the different phases, over a period of three months and the findings were analyzed. Results: Results of the study showed that Preanalytical errors were most common with a frequency of 148(42.8%), followed by analytical errors 114 (32.9%) and post analytical errors 84 (24.3%), respectively. Conclusions:The study concludes that pre-analytical, analytical, and post analytical errors are errors that compromise the quality of laboratory service delivery, which impacts on the patient management and diagnosis. Clinical laboratory errors can be minimized if due diligence and professionalism is adhered in the laboratory. The major mistakes in laboratory diagnostics arise during patient preparation, sample collection, sample preparation and sample storage. Most of these errors are due to the initial procedures of the testing process carried out by the healthcare personnel outside the laboratory walls and outside the direct control of the Clinical laboratory. A laboratory error is defined as a defect occurring at any part of the laboratory cycle, from ordering tests to reporting results and appropriately interpreting and reacting in these. According to these concepts, some practical considerations should be made in order to reduce errors in laboratory medicine and improve patient safety. 1 MATERIAL AND METHODSA total of 346 request forms, specimens/samples and dispatch of results were scrutinized and errors documented as per the different variables in the different phases, over a period of three months prospective study at the Clinical Chemistry Laboratory. RESULTSThe study findings indicate that the pre-analytical phase of the Clinical laboratory testing process had 148 errors which were 42.8% of the total number of errors captured during the study period. 74.3% (110) of the pre-analytical errors were attributed to: request forms lacking address (40, 27.0%); test not done in biochemistry lab (24, 16.2%); specimen drawn in wrong tube (20, 13.5%); specimen without request forms (10, 6.8%); unlabeled specimen (8, 5.4%); and inadequate/insufficient sample after centrifugation (8, 5.4%). The remaining 25.7% (38) of the pre-analytical phase errors are associate...

Total Clinical Chemistry Laboratory Errors and Evaluation of the Analytical Quality Control Using Sigma Metric for Routine Clinical Chemistry Tests

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