scholarly journals Preanalytical Variables: Role in laboratory testing

2019 ◽  
Vol 5 (6) ◽  
pp. 236-238
Author(s):  
Kanchan Singh ◽  
◽  
Abhas Kumar Singh ◽  
Keyword(s):  
Patient Care ◽  
Laboratory Testing ◽  
Clinical Biochemistry ◽  
Error Rates ◽  
Hospital Laboratory ◽  
Care And Treatment ◽  
Analytical Phase ◽  
Clinical Biochemistry Laboratory

Introduction: In present medical scenario diagnosis of various diseases largely depends on investigations performed at hospital laboratory and with the advancement of technology error rates in analytical phase reduced drastically but still preanalytical errors in laboratories are very common and play a very important role in patient care and treatment. Objectives: To identify the nature and frequency of pre-analytical factors responsible for sample rejection. Methodology: The study was conducted in Clinical Biochemistry laboratory of Department of Biochemistry, over a period of 6 months from October 2018- March 2019 on total 33,303 samples which include OPD samples (n=20040 ), IPD samples (n= 11488) and Emergency samples (n=1775) and in these samples different preanalytical variables were categorized separately. Results and Conclusion: Out of 33303 samples analysed over a period of 6 months preanalytical errors were seen in 1.38% (n=461) samples, with the commonest error was incomplete requisition forms followed by hemolysis of sample.

scholarly journals A study of pre-analytical errors in the clinical biochemistry laboratory at Victoria hospital, BMCRI, Bangalore

2022 ◽  
Vol 8 (4) ◽  
pp. 278-280
Author(s):  
Sreeja Shanker J ◽  
H L Vishwanath ◽  
Vibha C ◽  
Muralidhara Krishna
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Clinical Biochemistry ◽  
Phase Error ◽  
Percentage Error ◽  
Corrective Measures ◽  
Analytical Phase ◽  
Clinical Biochemistry Laboratory ◽  
Phase Evaluation ◽  
Analytical Errors

To categorize and calculate the percentage error of pre-analytical variables in the clinical biochemistry laboratory. Prospective observational study conducted for two months with documenting the frequency and type of pre-analytical errors occurring in venous samples. The total errors recorded were 1.31%. Insufficient volume followed by haemolysis amounted to a major proportion of errors. Continuous pre-analytical phase evaluation and taking corrective measures to make this phase error-free, have to be done.

scholarly journals RETROSPECTIVE EVALUATION OF PRE-ANALYTICAL ERRORS IN CLINICAL BIOCHEMISTRY LABORATORY AT A TERTIARY CARE CENTRE IN RAJSAMAND, RAJASTHAN.

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Richa K. Lath ◽  
Umeshkumar Pareek ◽  
Renu Sharma ◽  
Aniruddha N. Jibhkate ◽  
Ashish A. Jadhav ◽  
...  
Keyword(s):  
Clinical Biochemistry ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
Percentage Occurrence ◽  
Preventive Actions ◽  
Ensure Patient Safety ◽  
Different Types ◽  
Analytical Phase ◽  
Clinical Biochemistry Laboratory ◽  
Analytical Errors

Background: This study was carried out to identify the causes of pre-analytical errors in the clinical biochemistry laboratory and their percentage occurrence so as to formulate the strategy for necessary corrective and preventive actions. Methods: A retrospective quantitative study was conducted in the department of biochemistry to identify the different causes of pre-analytical errors in the outpatient and inpatient samples. The sample rejection register and test requisition forms for the period of May 2018 to April 2019 were analysed and the percentage occurrence of the different types of errors was calculated. Results: Data analysis revealed that the occurrence of different errors was as follows: hemolysis (46.43%), sample not received (28.32%), insufficient quantity (8.16%), improper collection technique (7.14%), delayed transport (5.87%), wrong container (1.79%), sample clotted (1.28%), lipemic sample (0.77%) and sample exchanged during separation in lab (0.26%). Conclusion: The decline in the errors during the analytical phase of sample processing has shifted the focus towards reducing errors occurring in the pre-analytical phase. This is necessary to ensure patient safety. Keywords: Pre-analytical errors, Biochemistry, hemolysis.

scholarly journals Clinical laboratory services for primary healthcare centers in urban cities: a pilot ACO model of ten primary healthcare centers

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Soha A. Tashkandi ◽  
Ali Alenezi ◽  
Ismail Bakhsh ◽  
Abdullah AlJuryyan ◽  
Zahir H AlShehry ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Quality Improvement ◽  
Primary Healthcare ◽  
Laboratory Testing ◽  
Gap Analysis ◽  
Reference Laboratory ◽  
Pilot Model ◽  
Laboratory Services ◽  
Analytical Phase ◽  
Primary Healthcare Centers

Abstract Background Primary healthcare centers (PHC) ensure that patients receive comprehensive care from promotion and prevention to treatment, rehabilitation, and palliative care in a familiar environment. It is designed to provide first-contact, continuous, comprehensive, and coordinated patient care that will help achieve equity in the specialty healthcare system. The healthcare in Saudi Arabia is undergoing transformation to Accountable Care Organizations (ACO) model. In order for the Kingdom of Saudi Arabia (KSA) to achieve its transformational goals in healthcare, the improvement of PHCs’ quality and utilization is crucial. An integral part of this service is the laboratory services. Methods This paper presents a pilot model for the laboratory services of PHC's in urban cities. The method was based on the FOCUS-PDCA quality improvement method focusing on the pre-analytical phase of the laboratory testing as well as the Saudi Central Board for Accreditation of Healthcare Institutes (CBAHI) gap analysis and readiness within the ten piloted primary healthcare centers. Results The Gap analysis, revealed in-consistency in the practice, lead to lower the quality of the service, which was seen in the low performance of the chosen key performance indicators (KPI's) (high rejection rates, lower turn-around times (TAT) for test results) and also in the competency of the staff. Following executing the interventions, and by using some of the ACO Laboratory strategies; the KPI rates were improved, and our results exceeded the targets that we have set to reach during the first year. Also introducing the electronic connectivity improved the TAT KPI and made many of the processes leaner. Conclusions Our results revealed that the centralization of PHC's laboratory service to an accredited reference laboratory and implementing the national accreditation standards improved the testing process and lowered the cost, for the mass majority of the routine laboratory testing. Moreover, the model shed the light on how crucial the pre-analytical phase for laboratory quality improvement process, its effect on cost reduction, and the importance of staff competency and utilization.

National survey on appropriateness of clinical biochemistry reporting in China

2015 ◽  
Vol 53 (11) ◽  
Author(s):  
Fengfeng Kang ◽  
Wei Wang ◽  
Zhiguo Wang
Keyword(s):  
Quality Indicators ◽  
National Survey ◽  
Clinical Biochemistry ◽  
Error Rates ◽  
Significant Difference ◽  
Survey Results ◽  
Complete Report ◽  
Term Monitoring ◽  
Reliable Testing

AbstractAccurate and reliable testing reports play an important role in the prevention, diagnosis, treatment and prognosis of disease. However, little is known about the appropriateness of laboratory testing reporting in China. This national survey takes clinical biochemistry as an example to investigate the state of reporting appropriateness in our country.An electronic questionnaire was sent to 1209 laboratories. The participants were asked to retrospectively evaluate the error rates of the following quality indicators: report template integrity, report content filling integrity, report delay, report recall, non-conformities between instrument and laboratory information system (LIS) data, non-conformities between report and request, report notification error, and report modification. Mann-Whitney and Kruskal-Wallis tests were used to identify the potential impacts of reporting appropriateness.A total of 662 of the 1209 laboratories (55%) submitted the survey results, with three returning incomplete data. For the integrity of the report, only 31% of the laboratories had a complete report template that contained all of 21 elements. In addition, the overall error rate of content filling integrity was 45.9% for 19,770 pieces of reports. The overall σ-values of other six quality indicators were all >4, and no significant difference was found among different departments. Group comparison suggested that reporting electronically had a better performance.The laboratory reporting system in China needs to improve, particularly the integrity of the report. Strengthening information technology will not only promote reporting appropriateness, but also guarantee accurate, standardized and traceable data collection and long-term monitoring.

scholarly journals High preanalytical non-compliance and samples rejection rate in clinical biochemistry laboratory are decreased by nurse staff training in phlebotomy and sample handling

2020 ◽  
Vol 13 (3) ◽  
pp. 113-118
Author(s):  
Modibo Coulibaly ◽  
Abdelaye Keita ◽  
Moussa Diawara ◽  
Valentin Sagara ◽  
Brehima Traoré ◽  
...  
Keyword(s):  
Staff Training ◽  
Clinical Biochemistry ◽  
Statistical Significance ◽  
Venous Blood ◽  
Diagnostic Errors ◽  
Hospital Staff ◽  
Clinical Samples ◽  
Sample Handling ◽  
Significant Difference ◽  
Clinical Biochemistry Laboratory

Background: Preanalytical phase of biomedical analysis remains an important source of diagnostic errors that deserves special attention. This study aims to evaluate the training in phlebotomy and sample handling impact on the preanalytical non-compliances. Material and Methods: we performed a prospective study before and after staff training in phlebotomy and sample handling by systematically recording all clinical samples non-compliances. First, we assessed and describe the non-compliance baseline rate from January to December 2017 in the clinical biochemistry laboratory of Hôpital Sominé DOLO de Mopti. After two sessions of one week staff training in January 2018, we performed the same study from January to December 2018. We compared the proportions of non-compliances between the two assessments. Data were collected on the case report forms, captured in Excel and analyzed by R software for (Mac) OS X version 4.0.3. Pearson Ch2 or Fisher exact tests were used for the comparison of proportions. The statistical significance was set at p < 5%. Results: a total of 27,810 venous blood samples were received during the study period; 48% was for biochemistry, 41% for immuno-serology, 9% for blood cell count and 2% for coagulation tests. There were 3,826 instances of preanalytical non-compliances (13.76%) identified that led to sample rejection. Out of the 11 types of non-compliances investigated, 5 (45.4%) accounted for nearly 91% of the problems: insufficient sample volume (28.9%), hemolyzed samples (20.5%), inappropriate collection time (17.8%), sample clot (12.9%), and inappropriate sample collection tube (10.8%). We observed a significant difference in rates of non-compliance between inpatients and outpatients samples (44.4% vs 7.3%; p < 0.001). The proportion of non-compliance have significatively decreased after the two training sessions of hospital staff in phlebotomy and sample handling 3,826/27,810 (13.8%) vs 3,009/32,476 (9.3%); p < 0.001. Conclusion: we report a significantly higher rate of non-compliance in inpatients. Hospital staff training in phlebotomy and sample handling reduce the proportion of preanalytical non-compliance and thereby improve patient management and safety.

scholarly journals Application of Sigma Metrics for Evaluating the Analytical Performance of Thyroid Profile and Cortisol in Clinical Biochemistry Laboratory

2020 ◽  
Author(s):  
Smita Natvarbhai Vasava ◽  
Roshni Gokaldas Sadaria
Keyword(s):  
Quality Control ◽  
Six Sigma ◽  
Clinical Laboratory ◽  
Clinical Biochemistry ◽  
Poor Performance ◽  
Analytical Performance ◽  
Internal Quality ◽  
Six Sigma Methodology ◽  
Clinical Biochemistry Laboratory ◽  
Thyroid Profile

Introduction: Now-a-days quality is the key aspect of clinical laboratory services. The six sigma metrics is an important quality measurement method for evaluating the performance of the clinical laboratory. Aim: To assess the analytical performance of clinical biochemistry laboratory by utilising thyroid profile and cortisol parameters from Internal Quality Control (IQC) data and to calculate sigma values. Materials and Methods: Study was conducted at Clinical Biochemistry Laboratory, Dhiraj General Hospital, Piparia, Gujarat, India. Retrospectively, IQC data of thyroid profile and cortisol were utilised for six subsequent months (July to December 2019). Coefficient of Variation (CV%) and bias were calculated from IQC data, from that the sigma values were calculated. The sigma values <3, >3 and >6 were indicated by poor performance procedure, good performance and world class performance, respectively. Results: The sigma values were estimated by calculating mean of six months. The mean sigma value of Thyroid Stimulating Hormone (TSH) and Cortisol were >3 for six months which indicated the good performance. However, sigma value of Triiodothyronine (T3), Tetraiodothyronine (T4) were found to be <3 which indicated poor performance. Conclusion: Six sigma methodology applications for thyroid profile and cortisol was evaluated, it was generally found as good. While T3 and T4 parameters showed low sigma values which requires detailed root cause analysis of analytical process. With the help of six sigma methodology, in clinical biochemistry laboratories, an appropriate Quality Control (QC) programming should be done for each parameter. To maintain six sigma levels is challenging to quality management personnel of laboratory, but it will be helpful to improve quality level in the clinical laboratories.

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