Reduction of preanalytical errors in clinical laboratory through multiple aspects and whole course intervention measures

• Published in: Journal of evidence-based medicine 2014-08, Vol.7 (3), p.172-177
• Main Authors: Li, Hong-ying, Huang, Xiang-ning, Yang, Yong-chang, Huang, Wen-fang, Chen, Li, Song, Ping, Zhang, Wen-yuan
• Format: Article
• Language: English
• Subjects: Anticoagulants; Associations; Clinical Laboratory Techniques - methods; Diagnostic Errors - prevention & control; Disqualified sample types; Humans; Intervention; Laboratories; multiple aspects and whole course intervention measures; preanalytical errors; Specimen Handling - methods
• ISSN: 1756-5383; 1756-5391; 1756-5391
• DOI: 10.1111/jebm.12115

Objective Errors in preanalytical phase decrease the accuracy of reports from clinical laboratory department. Considering the disqualified rate of preanalytical sample in our hospital, we performed several intervention measures to improve the situation. Methods The disqualified sample types and major causes of errors in the preanalytical phase were investigated in clinical laboratory department from September 2008 to August 2009. In the following year, we utilized multiple measures to properly intervene the key points of whole sample collection process, and the preanalytical errors were reanalyzed trimonthly, then the disqualification rate of total, major disqualified sample types and different test groups were calculated to evaluate the effects of the intervention measures. Results The total disqualification rate in the preanalytical phase obtained from September 2008 to August 2009 was 1.36%, and the major types of disqualified samples were coagulation of anticoagulant sample, sample inadequacy, sample container error, sample information error and sample type error. After one year intervention through key points of whole preanalytical sample collection process, the total disqualification rate dropped to 0.94%, and the disqualification rate of coagulation of anticoagulant sample, sample inadequacy, sample container error, sample information error, and sample type error decreased by 20.45%, 28.00%, 25.00%, 76.92%, and 66.66%, respectively. As for test groups, the decreasing amplitude of biochemical, routine, immunological, microbiological and emergency test group was 47.36%, 33.33%, 20.00%, 50.00%, and 21.43%, respectively. Conclusions The overall effect of the interventions is very good, and the disqualification rate of the main causes decreases to various degrees.