Int. Jr. Bioinformatic and Biological Sci. : v.2 n.3 and 4, p. 127-134. Dec. 2014

DOI No. 10.5958/2321-7111.2014.00010.9

Pre-analytical errors in clinical chemistry laboratory of a

tertiary care hospital in western Uttar Pradesh, India

Sangeeta Kapoor 1 , Anjali Verma 2* and Indu Saxena 3

1 Department of Biochemistry, TMMC and RC, Moradabad, India.

2 Department of Physiology, TMMC and RC, Moradabad, India.

3 Department of Biochemistry, AIIMS, Jodhpur, Rajasthan, India.

*Corresponding author: anjaliverma06071965@gmail.com

ABSTRACT

Background: Diagnosis of various diseases in the present medical scenario is

largely dependent on the tests performed in Clinical Chemistry Laboratory. TQM

(Total quantity Management) in a laboratory ensures that the results obtained be

free from errors. Objectives: To identify the nature and frequency of pre-analytical

causes of sample rejection and to take corrective steps. Methodology: This study

was conducted on 46,404 (OPD &IPD) samples and pre-analytical causes for

sample rejection were noted and the data was analysed. Results and Conclusion:

Pre-analytical errors were responsible for 2.32% (1077) of samples to be rejected

over a period of one year. Thus, substantial number of samples undergo repeated

testing because of rejection owing to pre-analytical errors.

Keywords: Total quality management (TQM), Pre-analytical errors, Clinical

Chemistry Laboratory.

Clinical chemistry laboratory plays a vital role in the diagnosis, treatment and

prognosis of patients in today’s medical scenario.TQM (total quality management)

is essential for generating accurate and reliable reports from the laboratory (Bonini

P et al , 2002). The process of sample testing in a clinical chemistry laboratory

is done in three phases: Pre-analytical, analytical and post-analytical. With

increasing automation in Clinical Chemistry Laboratory errors in the analytical

phase and post–analytical phase have been reduced to a great extent. Accuracy

in the analytical phase and post- analytical phase has largely been considered

for reporting from laboratory. On the contrary, importance of determining errors

in the pre-analytical phase has not largely been stressed upon. Errors during

collection and transport of biological specimens, errors in processing of the

samples and in patient’s data entry may occur. It has been reported that the errors

in the pre-analytical phase may occur to the extent of 60% (Bonini P et al , 2008).

Pre-analytical errors influence the total error thus hindering TQM in laboratory,

consequently decreasing the accuracy and reliability of the results generated.