Prevalence of Pre-Analytical Errors in Clinical Chemistry Diagnostic Labs in Sulaimani City of Iraqi Kurdistan

Najat, Dereen

doi:10.1371/journal.pone.0170211

Cited by 42 publications

(31 citation statements)

References 15 publications

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“…These errors included not wearing new gloves for each patient, not using 70% alcohol for cleaning the puncture site, retouching the cleaned site, collecting blood samples prior to alcohol drying, and applying tourniquets for a prolonged time, thereby not complying with CLSI guidelines. However, similar findings were observed in previous studies (22)(23)(24). The duration of tourniquet application of 59.2 (14.4) seconds in our study was within the recommended time.…”

Section: Discussionsupporting

confidence: 93%

Auditing of the phlebotomy system in medical laboratories in Port Sudan City, Sudan

Bashir¹,

Abdarabo²

2020

East Mediterr Health J

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Background: Phlebotomy is one of the most ignored techniques in laboratory medicine and health care. It is a complicated practice that requires wide knowledge and high-level skills. Mistakes in phlebotomy can influence laboratory results (diagnosis) and affect patient care. Aims: To appraise phlebotomists' practice and assess the extent of compliance with the guidelines and determine the frequency of errors in hospital laboratories in Port Sudan, Sudan. Methods: A cross-sectional observational study was conducted using a structured observation scheme in 8 Sudanese public hospitals between August and September 2017. A structured questionnaire was used to assess the venepuncture procedures. Five diverse blood collections by each phlebotomist were observed at each session. We monitored 120 blood collections by 24 phlebotomists, 16 (66.7%) male, and 8 (33.3%) female, with a mean age of 31.1 years. Results: Three of 8 phlebotomy sites were not covered by standard operating procedures (SOPs). Furthermore, phlebotomists lacked appropriate training plans. At 33.3% of the sessions, phlebotomists did not wear gloves at all, and in 69.2% sessions, they did not use new gloves for each patient. There was a significant correlation between phlebotomists' expertise and the duration of tourniquet application. Conclusion: This study demonstrates that SOPs were not available in some phlebotomy districts. Phlebotomists did not follow Clinical and Laboratory Standards Institute guidelines. Ongoing assessment and improvement of procedures are fundamental to ensure that the 1 / 9 WHO EMRO | Auditing of the phlebotomy system in medical laboratories in Port Sudan City, Sudan phlebotomy service operates effectively.

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Section: Discussionsupporting

confidence: 93%

Auditing of the phlebotomy system in medical laboratories in Port Sudan City, Sudan

Bashir¹,

Abdarabo²

2020

East Mediterr Health J

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“…Higher than this finding was reported from Croatia 65% 30 and Iran 74.1%. 31 Lower than this finding was reported from Iraqi Kurdistan 26% 32 of hemolyzed samples were used for analysis.…”

Section: Discussionmentioning

confidence: 87%

<p>Factors Affecting Quality of Laboratory Result During Ordering, Handling, and Testing of the Patient’s Specimen at Hawassa University College of Medicine and Health Science Comprehensive Specialized Hospital</p>

Fenta¹,

Ali²

2020

JMDH

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Background: The increase of medical laboratory test errors represents the increase of all defects within the process. An error can be any defect during the entire process, from ordering to reporting. It may have negative effects on patient care, by contributing to inappropriate treatment, an increase in lengths of hospital stay, and dissatisfaction with healthcare services. Therefore, this study aimed to determine factors affecting the quality of laboratory results through the entire process. Methods: A cross-sectional study was conducted at Hawassa University hospital from October 2018 to May 2019. Data were collected by using structured questionnaires and checklist and entered and analyzed using SPSS version 21. P-values less than 0.05 were considered statistically significant. Results: A total of 455 individuals participated in this study. During the actual observational assessment, 72.5% of laboratory professionals identify their patients correctly and 62.5% of them label the sample before collection. In multivariate logistic regression, labeling of sample before collection (AOR=1.357, 95% CI=1.09, 1.58, P-0.017), use of unmixed (AOR=4.364, 95% CI=1.950, 20.036, P-0.049) and hemolyzed blood for testing (AOR=1.403, 95% CI=1.096, 1.692 P-0.021) were associated with laboratory test errors. The clinical service providers who requested the test believed, lack of efficient laboratory service (P=0.005), unable to use manuals (P=0.025), and incorrect interpretation of reference booklets were associated with laboratory errors. Patient residence and frequency of first and second visits of the hospital were statistically associated with laboratory errors. Conclusion: The occurrence of laboratory errors in our study was demonstrated by the distribution pattern, the preanalytical, analytical, and post-analytical steps. But changes have occurred in the types and frequencies of errors in these phases of testing by laboratory professionals, clinicians, and patients in the current study. Therefore, the hospital administrations, laboratory professionals and clinicians should work harder and closer to solve the identified problems.

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“…[89] There have been considerable advances in the analytical part of the testing including equipment technology, automation, computer software, and implementation of quality control programs which have reduced the analytical errors to a great extent. [91011] However, in the preanalytical areas, majority of processes are still manual. A study by the American College of Pathologists observed that the most common reason for errors in the preanalytical setting is human error at about 82.6% and technical errors at only 4.3%.…”

Section: Discussionmentioning

confidence: 99%

Reduction in sample rejections at the preanalytical phase – Impact of training in a tertiary care oncology center

et al. 2019

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CONTEXT: Major clinical decisions are based on the laboratory test results where preanalytical errors are an important cause of repeat collections in patients. Identification of problem areas and continuous training of phlebotomy staff are important tools in reducing these errors. AIMS: In this study, we looked at the most common causes of sample rejection in our setting and the efficacy of the corrective measures and training processes for staff in reducing preanalytical errors. SETTINGS AND DESIGNS: This prospective study was conducted at the laboratory diagnostic services of a tertiary care oncology center, with a hematopoietic stem cell transplant unit during the period of 2012–2017 in two phases. Sample rejections from various wards were analyzed for types of rejections. MATERIALS AND METHODS: In the first phase, we analyzed the problem areas (year 2012). Following a root cause analysis, current practices of training were altered. In the second phase (2013–2017), we studied the effects of these measures. STATISTICAL ANALYSIS USED: The percent variation and P value for significance in sample rejections were calculated. RESULTS: During the year 2012, 0.36% samples were rejected by laboratory. Following interventions in the period from 2013 to 2017, samples rejected dropped to 0.19% (P < 0.0001), 0.09% (P < 0.0001), 0.09% (P = 0.8387), 0.05% (P = 0.0004), and 0.05% (P = 0.329), respectively. The reduction was significant from surgical oncology ward (P = 0.0107) and intensive care unit (P = 0.0007). From 2013 to 2017, errors significantly reduced to 0.015% for hemolyzed samples (P = 0.0001), 0.005% for contaminated samples, 0.036% for clotted samples, and 0.019% for labeling errors. CONCLUSION: Intervention in the form of targeted training helps reduce errors and improves the quality of results generated and contributes to better clinical outcomes.

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Prevalence of Pre-Analytical Errors in Clinical Chemistry Diagnostic Labs in Sulaimani City of Iraqi Kurdistan

Cited by 42 publications

References 15 publications

Auditing of the phlebotomy system in medical laboratories in Port Sudan City, Sudan

Auditing of the phlebotomy system in medical laboratories in Port Sudan City, Sudan

<p>Factors Affecting Quality of Laboratory Result During Ordering, Handling, and Testing of the Patient’s Specimen at Hawassa University College of Medicine and Health Science Comprehensive Specialized Hospital</p>

Reduction in sample rejections at the preanalytical phase – Impact of training in a tertiary care oncology center

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