Quality indicators and specifications for key processes in clinical laboratories: a preliminary experience

Kirchner, María Jesús Alsina; Funes, Virtudes Álvarez; Biosca, Carmen; Clar, Maria Vicenta Doménech; Ibarz, Mercè; Girona, J. Minchinela; Barellas, Rosa Maria Pastor; Alsina, Carmen Perich; Aguilá, Carmen Ricós; Isern, Gloria Trujillo; Navarro, Conrad Vilanova

doi:10.1515/cclm.2007.122

Cited by 51 publications

(17 citation statements)

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“…In the preliminary study on quality indicators, error rates in preanalytical indicators such as erroneous request, erroneous sample, and samples that were not taken were found as 4.1%, 5% and 1.7%, respectively ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

Clinical biochemistry laboratory rejection rates due to various types of preanalytical errors

et al. 2014

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Introduction:Preanalytical errors, along the process from the beginning of test requests to the admissions of the specimens to the laboratory, cause the rejection of samples. The aim of this study was to better explain the reasons of rejected samples, regarding to their rates in certain test groups in our laboratory.Materials and methods:This preliminary study was designed on the rejected samples in one-year period, based on the rates and types of inappropriateness. Test requests and blood samples of clinical chemistry, immunoassay, hematology, glycated hemoglobin, coagulation and erythrocyte sedimentation rate test units were evaluated. Types of inappropriateness were evaluated as follows: improperly labelled samples, hemolysed, clotted specimen, insufficient volume of specimen and total request errors.Results:A total of 5,183,582 test requests from 1,035,743 blood collection tubes were considered. The total rejection rate was 0.65 %. The rejection rate of coagulation group was significantly higher (2.28%) than the other test groups (P < 0.001) including insufficient volume of specimen error rate as 1.38%. Rejection rates of hemolysis, clotted specimen and insufficient volume of sample error were found to be 8%, 24% and 34%, respectively. Total request errors, particularly, for unintelligible requests were 32% of the total for inpatients.Conclusions:The errors were especially attributable to unintelligible requests of inappropriate test requests, improperly labelled samples for inpatients and blood drawing errors especially due to insufficient volume of specimens in a coagulation test group. Further studies should be performed after corrective and preventive actions to detect a possible decrease in rejecting samples.

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Section: Discussionmentioning

confidence: 99%

Clinical biochemistry laboratory rejection rates due to various types of preanalytical errors

et al. 2014

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“…Errors related to ID or barcode linkage can cause delay or incorrect ordering of analysis, thereby delivering inaccurate test results to the patient [2,20,22]. Still, despite the intervention, 16% of the IG PHC phlebotomists reported that they sometimes labelled the test tube at a later occasion or allowed somebody else to label afterward, which is unacceptable.…”

Section: Discussionmentioning

confidence: 99%

“…A common reason for specimen rejection and renewed sampling is specimen haemolysis, which most often is due to incorrect specimen collection including prolonged venous stasis and not sufficiently filled tubes [1,10,17-19]. Common specimen handling errors include incorrect test tube labelling [2,15,20,21], incorrect test request management, missing tubes, and transport errors [2,8,10,14,22]. …”

Section: Introductionmentioning

confidence: 99%

Impact of a large-scale educational intervention program on venous blood specimen collection practices

Bölenius

Lindkvist

Brulin

et al. 2013

BMC Health Serv Res

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BackgroundPhlebotomy performed with poor adherence to venous blood specimen collection (VBSC) guidelines jeopardizes patient safety and may lead to patient suffering and adverse events. A first questionnaire study demonstrated low compliance to VBSC guidelines, motivating an educational intervention of all phlebotomists within a county council. The aim was to evaluate the impact of a large-scale educational intervention program (EIP) on primary health care phlebotomists’ adherence to VBSC guidelines. We hypothesised that the EIP would improve phlebotomists’ VBSC practical performance.MethodsThe present study comprise primary health care centres (n = 61) from two county councils in northern Sweden. The final selected study group consisted of phlebotomists divided into an intervention group (n = 84) and a corresponding control group (n = 79). Both groups responded to a validated self-reported VBSC questionnaire twice. The EIP included three parts: guideline studies, an oral presentation, and an examination. Non-parametric statistics were used for comparison within and between the groups.ResultsEvaluating the EIP, we found significant improvements in the intervention group compared to the control group on self-reported questionnaire responses regarding information search (ES = 0.23-0.33, p < 0.001-0.003), and patient rest prior to phlebotomy (ES = 0.27, p = 0.004). Test request management, patient identity control, release of venous stasis, and test tube labelling had significantly improved in the intervention group but did not significantly differ from the control group (ES = 0.22- 0.49, p = < 0.001- 0.006). The control group showed no significant improvements at all (ES = 0–0.39, p = 0.016-0.961).ConclusionsThe present study demonstrated several significant improvements on phlebotomists’ adherence to VBSC practices. Still, guideline adherence improvement to several crucial phlebotomy practices is needed. We cannot conclude that the improvements are solely due to the EIP and suggest future efforts to improve VBSC. The program should provide time for reflections and discussions. Furthermore, a modular structure would allow directed educational intervention based on the specific VBSC guideline flaws existing at a specific unit. Such an approach is probably more effective at improving and sustaining adherence to VBSC guidelines than an EIP containing general pre-analytical practices.

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“…При этом сохраняется недостаток внимания к внелабораторным этапам исследования, что резко контрастирует с многочисленными исследованиями разнообразных ошибок, которые происходят на пре-и постаналитических этапах. В последнее время в некоторых странах и регионах (Австралия и Новая Зеландия [8], Бразилия [9], Каталония [10]) уже разработаны программы оценки ИК внелабораторных этапов исследования, в других подобные исследования анонсированы (Великобритания [11,12], Китай и Хорватия [13]).…”

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Harmonization of quality indicators in laboratory medicine. A preliminary consensus

Astion¹,

Barth²,

Galoro³

et al. 2018

Lab. sluzh.

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Quality indicators and specifications for key processes in clinical laboratories: a preliminary experience

Cited by 51 publications

References 1 publication

Clinical biochemistry laboratory rejection rates due to various types of preanalytical errors

Clinical biochemistry laboratory rejection rates due to various types of preanalytical errors

Impact of a large-scale educational intervention program on venous blood specimen collection practices

Harmonization of quality indicators in laboratory medicine. A preliminary consensus

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