Errors in the Hematology Laboratory at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

Tadesse, Hirut; Desta, Kassu; Kinde, Samuel; Hassen, Fatuma; Gize, Addisu

doi:10.1186/s13104-018-3551-y

Cited by 10 publications

(34 citation statements)

References 24 publications

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“…This result was higher than the study done at St Paul’s Hospital Millennium Medical College, 6.4%. 16 …”

Section: Discussionmentioning

confidence: 99%

Magnitude of extra-analytical errors and associated factors in medical laboratories in thirteen Public Hospitals in Addis Ababa, Ethiopia

Degfe¹,

Mohammed

2023

SAGE Open Medicine

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Background: Currently, more than two-thirds of medical decisions are made based on laboratory test results. However, due to the compromised pre-analytical and post-analytical phases (or extra-analytical phase), the reporting of incorrect or inappropriate test results was still prevalent. Studies focusing on the prevalence of and factors associated with laboratory error remain very limited in Ethiopia. Objective: This study aimed to assess the magnitude of extra-analytical errors and associated factors in medical laboratory services in 13 public hospitals in Addis Ababa, Ethiopia, from January to April 2020. Materials and Methods: A hospital-based cross-sectional study was conducted in the medical laboratories of public hospitals in Addis Ababa from January to April 2020 to assess extra-analytical errors and associated factors. Data were collected from 2401 laboratory request forms ordered within the study period and 169 laboratory professionals working in public hospitals. The collected data were entered and analyzed using SPSS version 23 software. Data were analyzed using simple descriptive statistics, percentages, and frequencies and summarized using tables and text. Bivariate logistic regression analysis was conducted, and variables (with a p value below 0.25) were included in the multivariate logistic regression model. A p value <0.05 was considered a cutoff point in the final model. Results: In this study, of the errors detected, 60.3% occurred in the pre-analytical phase and 39.7% in the post-analytical phase. Extra-analytical errors in laboratory services were significantly associated with lack of written procedures for laboratory activities (adjusted odds ratio = 2.79, 95% confidence interval = 1.34–5.86), 1–2 years of work experience (adjusted odds ratio = 5.5, 95% confidence interval = 2.54–9.31), work experience (3–5 years) (adjusted odds ratio = 2.67, 95% confidence interval = 0.94–4.56), and education (diploma) (adjusted odds ratio = 6.30, 95% confidence interval = 2.17–12.26). Conclusion: This study discovered errors in the pre-analytical (60.3%) and post-analytical (39.7%) phases, and none of the requisition papers had complete data. This frequency may be affected by workload, a lack of written procedures, the number of years of work experience, and the level of education of the staff.

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“…This result was higher than the study done at St Paul’s Hospital Millennium Medical College, 6.4%. 16 …”

Section: Discussionmentioning

confidence: 99%

Magnitude of extra-analytical errors and associated factors in medical laboratories in thirteen Public Hospitals in Addis Ababa, Ethiopia

Degfe¹,

Mohammed

2023

SAGE Open Medicine

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“…it is obligatory to take it into consideration when interpreting the reports exploring haemostasis [4]. A study carried out in 2018 [6], showed the absence of the mention sex of the patient from the prescription card in 10.3% of the total of the prescription cards received in the laboratory. In our survey, each patient's sex was marked on the corresponding prescription form.…”

Section: Discussionmentioning

confidence: 99%

“…Mention of the age or date of birth of the patient on the prescription form is essential for correct interpretation [10][11][12]. In the series of Tadesse et al [6], 11.5% of cards did not mention the age of the patient. In our series, age was not mentioned on 27% of the total number of cards received.…”

Section: Discussionmentioning

confidence: 99%

“…This allows the biologist to correctly interpret the results obtained, and also to act by carrying out, if necessary, additional examinations that can provide more details for the diagnosis [1,4,[13][14][15][16]. In the series of Tadesse et al [6], clinical and therapeutic information was on prescription cards in 70.1% of cases. In our series, they were mentioned only in 13% of cases and absent in 87% of all prescriptions received.…”

Section: Discussionmentioning

confidence: 99%

“…The rate of under-filling tubes from services (28%) was higher than that of tubes received from the blood drawing room (19%). Our rates are high by comparing them to the rates of similar studies [5][6][7][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

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Pre-analytical Phase in Hemostasis: The Main Anomalies and Means to Correct Them

Siham¹,

Ikhlas²,

Raihane³

et al. 2019

AJLM

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Pre-analytical errors still represent nearly 70% of all errors occurring in the laboratory, constituting a danger, a waste of time and an additional cost to the patient. The control of the different components of the pre-analytical step is important for the validity of the hemostasis exploration tests. The purpose of our work is to identify the main anomalies of the pre-analytical phase in hemostasis and to propose the means to correct them. We conducted a prospective and descriptive study on the pre-analytical phase of hemostasis. It was in the form of a survey, identifying the main errors related to this phase. It was performed at the Hematology laboratory of the Avicenna Military Hospital of Marrakech and spread over a period of 4 weeks. Our investigation took place at the hemostasis room, which received the collection tubes from the various hospital departments and the blood drawing room (for non-hospitalized patients). The hemostasis room received 400 prescription cards and their corresponding tubes. The parameters related to the prescription file: full name and gender of the patients, were mentioned on all the cards received and they were in conformity with those marked on the corresponding tube. The age of the patients and their clinical and therapeutic informations were mentioned in 73% and 13% of the exam requests, respectively. For the pre-analytical hemostasis parameters related to the blood collection: 63% of samples were taken at the laboratory's blood drawing room, while 37% came from the various hospital departments. Time of the realization of the samples was not mentioned on the cards or on the labels of the tubes. The anticoagulant used for all samples was sodium citrate at a concentration of 3.8%. The filling of the tubes was noncompliant in 22.25%. Registration and triage of the tubes systems were manual. Centrifugation was carried out at a rotation speed of 5000 G for 5 minutes and at a temperature set at 22°C. Hemolyzed samples accounted for 3% of the tubes.

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Assessment of hematology laboratory performance in the total testing process using quality indicators and sigma metrics in the northwest of Ethiopia: A cross‐sectional study

Berta,

Grima,

Melku

et al. 2024

Health Science Reports

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Background and AimsAssuring laboratory quality by minimizing the magnitude of errors is essential. Therefore, this study aimed to assess hematology laboratory performance in the total testing process using quality indicators and sigma metrics.MethodsA cross‐sectional study was conducted from April to June 2022. The study included a total of 13,546 samples. Data on included variables were collected using a checklist. Descriptive statistics were used to present the overall distribution of errors. Binary logistic regression models were applied. Furthermore, using a Sigma scale, the percentage of errors was converted to defects per million opportunities to assess laboratory performance. Finally, the defect per million opportunities was converted to a sigma value using a sigma calculator.ResultsOf the 13,546 samples and corresponding requests, the overall error rate was 123,296/474,234 (26%): 93,412/47,234 (19.7%) pre‐analytical, 2364/474,234 (0.5%) analytical, and 27,520/474,234 (5.8%) post‐analytical. Of the overall errors, 93,412/123,296 (75.8%), 2364/123,296 (1.9%), and 27,520/123,296 (22.3%) were pre‐analytical, analytical, and post‐analytical errors, respectively. The overall sigma value of the laboratory was 2.2. The sigma values of the pre‐analytical, analytical, and post‐analytical phases were 2.4, 4.1, and 3.1, respectively. The sample from the inpatient department and collected without adherence to the standard operating procedures (SOPs) had a significantly higher (p < 0.05) rejection rate as compared to the outpatient department and collected with adherence to SOPs, respectively. In addition, an association between prolonged turnaround times and manual recording, inpatient departments, and morning work shifts was observed.ConclusionThe current study found that the overall performance of the laboratory was very poor (less than three sigma). Therefore, the hospital leadership should change the manual system of ordering tests and release of results to a computerized system and give need‐based training for all professionals involved in hematology laboratory sample collection and processing.

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Errors in the Hematology Laboratory at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

Cited by 10 publications

References 24 publications

Magnitude of extra-analytical errors and associated factors in medical laboratories in thirteen Public Hospitals in Addis Ababa, Ethiopia

Magnitude of extra-analytical errors and associated factors in medical laboratories in thirteen Public Hospitals in Addis Ababa, Ethiopia

Pre-analytical Phase in Hemostasis: The Main Anomalies and Means to Correct Them

Assessment of hematology laboratory performance in the total testing process using quality indicators and sigma metrics in the northwest of Ethiopia: A cross‐sectional study

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