Pre-analytical Errors in the Hematology Laboratory of Teaching Hospital Rathnapura: A Cross-sectional Study.

Abstract

Background: A precise and accurate of laboratory report is essential for guiding towards better clinical decisions. Laboratory errors can cause delays in diagnosis and treatment. The pre analytical phase, defined as the period from patient preparation through sample collection, transportation, and storage until the beginning of the analytical phase, is particularly prone to errors. Pre-analytical errors (PEs) are the most common type of errors in the Total Testing Process (TTP), accounting for about 70% of total laboratory errors. Objective: To assess the PEs in the haematology laboratory in teaching hospital Rathnapura Methods: A prospective cross-sectional study was conducted involving 21 600 samples from inpatient departments (IPD), received to the sample receiving counter of the haematology laboratory at teaching hospital Rathnapura. Results were expressed as frequencies and percentages. Chi-Square test was used to determine the significance among the variables using SPSS version 22.0. Results: Clotted samples, insufficient samples, over volume samples, insufficient details, diluted, non-sample decomposed, haemolysed samples, incorrect details, without request forms, incorrect containers, incorrect samples, no label on samples were found as the PEs. The overall percentage of PE was 2.81% (607/21600). Among these, the most frequent error was clotted samples (2.02%, 437/21600) followed by insufficient samples (0.36%, 79/21600). The least issue was no proper labeling (0.004%). The majority of PEs were reported from medical (1.23%) and surgical (0.51%) wards among IPD. However, there was no statistical significance among the wards (p=0.153). Among the tests requested by IPD, full blood count was the most frequently rejected test due to clotting. The sample population was evenly distributed among gender. The highest incidence of PEs was reported for the samples of the patients aged 55-74 years. Conclusion: Clotted samples and insufficient samples are the most commonly observed PEs, which are identified in the medical and surgical wards. The staffs who are engaged in collection, transportation and handling of the specimens should be well trained to reduce or minimize those errors.