Pre-analytical errors in Clinical Chemistry Laboratory of a Tertiary care Hospital
were found to be improper phlebotomy techniques, blood collected in insufficient
amount of additive in the tube, traumatic venipuncture , abrupt freezing and
thawing ,vigorous shaking of tubes after collection and transfusing of the blood
directly from a small diameter needle. Technical staff was made aware about all
these factors leading to haemolysed samples and to take measures to avoid them.
It was found that the clotted blood sample reaching the laboratory could be done
away with blood collection in proper anticoagulant tubes and proper vacutainers.
Collecting the blood in proper vacutainers which are easily identifiable by colour
coding would also ensure avoidance of wrong results due to incorrect volume of
the sample reaching the laboratory (Shashi Upreti et al , 2013). It was seen that
prompt transfer of the sample from the blood collection unit to the laboratory
was good enough for avoiding wrong timing of the sample. Moreover, it was
emphasized that giving proper instructions to patients regarding collection of
timed samples will also go a long way in avoiding such type of errors. Insufficient
volume also accounted for false results in substantial number of patients for
which the technical staff were directed to practice proper phlebotomy techniques
and the use of vacutainers for the collection of blood samples. Mislabelling or
misidentification of the samples was seen in 7.06% of the patients which were
similar to the finding obtained by (Bonini P et al , 2008). Misidentification in terms
of errors in recording name, sex, sample number, tests recommended and even
double entry was recorded for the blood samples. Lipemic samples were identified
for 4.92% patients which was the least common factor responsible in our study.
Technical staff was guided to use lipemia clearing agent and dilution techniques in
such samples to avoid errors due to lipemia.
Conclusion
Pre-analytical phase is a lesser identified area for the occurrence of errors in a
ClinicalChemistryLaboratorywhichcanaccounttoalargeextentforthegeneration
of faculty reports from the laboratory (Chawala R et al , 2010). Frequency, type
and percentage occurrence of these errors must be identified in each laboratory so
that corrective measures may be taken to overcome these errors.
Inferences
(Firdushi Begum, 2014).
transport (Szecsi P B et al , 2009).
collection.
International Journal of Bioinformatics and Biological Sciences : v.2 n.3&4. Dec. 2014
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