Errors in a Stat Laboratory: Types and Frequencies 10 Years Later

Abstract

Background: In view of increasing attention focused on patient safety and the need to reduce laboratory errors, it is important that clinical laboratories collect statistics on error occurrence rates over the whole testing cycle, including pre-, intra-, and postanalytical phases. Methods: The present study was conducted in 2006 according to the design we previously used in 1996 to monitor the error rates for laboratory testing in 4 different departments (internal medicine, nephrology, surgery, and intensive care). For 3 months, physicians and nurses were asked to pay careful attention to all test results. Any suspected laboratory error was recorded with associated pertinent clinical information. Every day, a laboratory physician visited the 4 departments and a critical appraisal was made of any suspect results. Results: Among a total of 51 746 analyses, clinicians notified us of 393 questionable findings, 160 of which were confirmed as laboratory errors. The overall frequency of errors, 3092 ppm, was significantly lower (P <0.05) than in 1996 (4700 ppm). Of the 160 confirmed errors, 61.9% were preanalytical errors, 15% were analytical, and 23.1% were postanalytical. Conclusions: During the last decade the error rates in our stat laboratory have been reduced significantly. As demonstrated by the distribution pattern, the pre-and postanalytical steps still have the highest error prevalences, but changes have occurred in the types and frequencies of errors in these phases of testing.

Performance criteria and quality indicators for the pre-analytical phase

“…In particular, two papers published in 1997 and 2007 [8,9] using one study design allowed us to investigate most TTP steps in the same clinical context. In both studies, the pre-analytic phase had the highest error rate, the most frequent problems arising from mistakes in tube filling, inappropriate containers, and requesting procedures.…”

Effective communication of molecular genetic test results to primary care providers

“…Therefore, effective communication between the genetic testing laboratory and ordering clinician is essential for optimal test utilization and interpretation. [5][6][7][8] Unfortunately, clinicians frequently have difficulty understanding the implications of genetic tests results, [9][10][11][12][13] and they express dissatisfaction with clinical genetic test reports. 14 This is likely due partly to variation in reporting of molecular genetic test results.…”

Preanalytical variables and factors that interfere with the biochemical parameters: A review

“…Therefore, studies reveal different error rates about, however there is a consensus that the preanalytical phase constitutes the big portion 2,44 ( Figure 3). It is also noted that, the pre-and postanalytical errors were defined as human dependent and preventable, for which the rate was recorded as 73.1% 44 . The most frequent problem in the preanalytical phase arises from the mistakes in the tube filling, inadequate anticoagulant-blood ratio which was followed by patient misidentification 44 .…”