Impact of Educational Activities in Reducing Pre-Analytical Laboratory Errors: A quality initiative

Abstract

Objectives: Pre-analytic errors during diagnostic laboratory investigations can lead to increased patient morbidity and mortality. This study aimed to ascertain the effect of educational nursing activities on the incidence of pre-analytical errors resulting in non-conforming blood samples. Methods: This study was conducted between January 2008 and December 2015. All specimens received at the Haematology Laboratory of the Sultan Qaboos University Hospital, Muscat, Oman, during this period were prospectively collected and analysed. Similar data from 2007 were collected retrospectively and used as a baseline for comparison. Non-conforming samples were defined as either clotted samples, haemolysed samples, use of the wrong anticoagulant, insufficient quantities of blood collected, incorrect/lack of labelling on a sample or lack of delivery of a sample in spite of a sample request. From 2008 onwards, multiple educational training activities directed at the hospital nursing staff and nursing students primarily responsible for blood collection were implemented on a regular basis. Results: After initiating corrective measures in 2008, a progressive reduction in the percentage of non-conforming samples was observed from 2009 onwards. Despite a 127.84% increase in the total number of specimens received, there was a significant reduction in non-conforming samples from 0.29% in 2007 to 0.07% in 2015, resulting in an improvement of 75.86% (P <0.050). In particular, specimen identification errors decreased by 0.056%, with a 96.55% improvement. Conclusion: Targeted educational activities directed primarily towards hospital nursing staff had a positive impact on the quality of laboratory specimens by significantly reducing pre-analytical errors. Keywords

Impact of potassium test sample rejections on routine laboratory service, South Africa

“…A study investigating the impact of educational training among nurses in a hospital in Oman in 2017 showed about 75.9% improvement in sample quality after re-training. 30 The availability of specially trained phlebotomy personnel within a facility is important not just for proper blood sample collection, but also to ease the workload on the already overworked nurses and doctors, who may tend to rush sample collection due to the increased workload. 30 Haemolysed samples certainly pose a serious challenge for clinical laboratories.…”

“…30 The availability of specially trained phlebotomy personnel within a facility is important not just for proper blood sample collection, but also to ease the workload on the already overworked nurses and doctors, who may tend to rush sample collection due to the increased workload. 30 Haemolysed samples certainly pose a serious challenge for clinical laboratories. 7 Contamination by EDTA-K anticoagulant as a cause of pseudohyperkalaemia accounted for 6.3% of the potassium rejections in this study and is common in clinical chemistry laboratories.…”

Progress in Biosensors for the Point-of-Care Diagnosis of COVID-19

“…The mentioned methods generally exert good accuracy and reliability. On the other hand, common laboratory assays require reliable and expensive equipment and infrastructure, systematic quality control, instrument services and experienced and educated personnel to be performed [ 43 , 44 , 45 , 46 , 47 ]. During the COVID-19 pandemic, simple means of diagnosing the disease or detecting the presence of covid antigens or other markers were highly desired and were helpful when available in sufficient numbers and at a low price at the same time.…”

Quality Improvement Efforts in Pre-Analytical Phase

“…It was also reported that an error in sample identification reduced by 0.056% and led to 96.55% improvement. A positive impact of this intervention was a 127.84% increase in the total 21 number of specimens received.…”