Assessment of Pre-Analytical Phase Quality Across Clinical Laboratories in the Valle de Aburrá - Colombia

• Lina María Ospina Gallego University Institution Colegio Mayor de Antioquia, Colombia https://orcid.org/0000-0002-9086-5686
• Juan Felipe Zapata Martínez University of Antioquia, Colombia https://orcid.org/0000-0001-8782-945X
• Claudia María Cuervo Araque University Institution Colegio Mayor de Antioquia, Colombia https://orcid.org/0000-0002-4133-7422

DOI: https://doi.org/10.5281/zenodo.20139297

Keywords: Biochemical analysis, Quality control, Laboratory work, Scientific research

Abstract

The pre-analytic phase covers in chronological order; From the physician's request, indication, patient preparation, obtaining the primary sample, transportation to and within the laboratory, and ending when the analytical procedure begins. The objective of this study was to evaluate quality practices in the pre-analytical phase of different clinical laboratories of the Metropolitan Area of ​​the Valley of Aburrá. A descriptive cross-sectional study was carried out during, where 14 laboratories were analyzed, Secretaries, laboratory assistants, bacteriologists and physicians. As results, it was obtained that the requests for examinations are made in printed form by the attending physician in 85.7% of the laboratories, verbal requests are not made in 42.9%, If abnormalities are found in the order, it is verified with the doctor. 64.3%, the auxiliary staff is given training for the sample 71.4%, and who provides the indications for the analysis is the secretary or receptionist in 42, 9%. 87.55% of the laboratories have a manual for the pre-analytical phase and 71.4% of the auxiliaries knew the manual in the training of sampling. When there is an error in the request for the exams Errors such as patient name are given in 42.9% and verification with patients of the conditions for sampling in 85.7% of laboratories evaluated. It can be evidenced that in the laboratories surveyed the quality conditions in the processes of the pre-analytic phase must be improved since they are not being fulfilled according to the norms established by the Systems of Quality Management.

References

Ashavaid, T. F., Dandekar, S. P., Khodaiji, S., Ansari, M. H., & Singh, A. P. (2009). Influence of method of specimen collection on various preanalytical sample quality indicators in EDTA blood collected for cell counting. Indian Journal of Clinical Biochemistry, 24(4), 356–360. https://doi.org/10.1007/s12291-009-0064-4

Belles Sampera, J., Ventura Pedret, S., Gomis Castellvi, M., & Miquel March Amengual, J. (2012). Rutas de recogida de muestras y error en el proceso analítico. Revista Del Laboratorio Clínico, 5(1), 10–17. https://doi.org/10.1016/j.labcli.2011.09.002

Bonini, P., Plebani, M., Ceriotti, F., & Rubboli, F. (2002). Errors in Laboratory Medicine. Clinical Chemistry, 48(5), 691–698. https://doi.org/10.1093/clinchem/48.5.691

Carraro, P., & Plebani, M. (2007). Errors in a Stat Laboratory: Types and Frequencies 10 Years Later. Clinical Chemistry, 53(7), 1338–1342. https://doi.org/10.1373/clinchem.2007.088344

Cornes, M. P., Church, S., van Dongen-Lases, E., Grankvist, K., Guimarães, J. T., Ibarz, M., Kovalevskaya, S., Kristensen, G. B., Lippi, G., Nybo, M., Sprongl, L., Sumarac, Z., & Simundic, A.-M. (2016). The role of European Federation of Clinical Chemistry and Laboratory Medicine Working Group for Preanalytical Phase in standardization and harmonization of the preanalytical phase in Europe. Annals of Clinical Biochemistry: International Journal of Laboratory Medicine, 53(5), 539–547. https://doi.org/10.1177/000456321664396

Florkowski, C., Don-Wauchope, A., Gimenez, N., Rodriguez-Capote, K., Wils, J., & Zemlin, A. (2017). Point-of-care testing (POCT) and evidence-based laboratory medicine (EBLM) – does it leverage any advantage in clinical decision making? Critical Reviews in Clinical Laboratory Sciences, 54(7–8), 471–494. https://doi.org/10.1080/10408363.2017.1399336

Guder, W. G. (2014). History of the preanalytical phase: a personal view. Biochemia Medica, 25–30. https://doi.org/10.11613/BM.2014.005

Hofgärtner, W. T., & Tait, J. F. (1999). Frequency of Problems During Clinical Molecular-Genetic Testing. American Journal of Clinical Pathology, 112(1), 14–21. https://doi.org/10.1093/ajcp/112.1.14
International Organization for Standardization. (2022, December). ISO 15189:2022. ISO. https://www.iso.org/standard/76677.html

Plebani, M. (2010). The detection and prevention of errors in laboratory medicine. Annals of Clinical Biochemistry: International Journal of Laboratory Medicine, 47(2), 101–110. https://doi.org/10.1258/acb.2009.009222

Plebani, M., & Carraro, P. (1997). Mistakes in a stat laboratory: types and frequency. Clinical Chemistry, 43(8), 1348–1351. https://doi.org/10.1093/clinchem/43.8.1348

Rodziewicz, T. L., Houseman, B., Vaqar, S., & Hipskind, J. E. (2024, 12 febrero). Medical Error Reduction and Prevention. StatPearls - NCBI Bookshelf. http://www.ncbi.nlm.nih.gov/books/NBK499956/

Roger, A. J., Braos, J. L., Nogueras, R. M., Morales, R. R., De la Peña Carretero, L., & Sotomayor, M. R. (2012). La gestión por procesos en el laboratorio clínico como herramienta para disminuir los errores preanalíticos. Dialnet. https://dialnet.unirioja.es/servlet/articulo?codigo=3910075

Siesquen Silva, J. (2022). Relación entre las variables pre-analíticas y el desempeño de las pruebas del perfil de coagulación, hospital de Lambayeque, 2021. Universidad Privada Norbert Wiener. Disponible en: https://hdl.handle.net/20.500.13053/6496

Soledad, F. M., & De Enfermería y Fisioterapia, U. P. C. E. U. (2018). Errores preanalíticos en el laboratorio por acción directa del personal de enfermería. https://repositorio.comillas.edu/xmlui/handle/11531/35905

Statland, B. E., & Winkel, P. (1977). Effects of preanalytical factors on the intraindividual variation of analytes in the blood of healthy subjects: consideration of preparation of the subject and time of venipuncture. CRC critical reviews in clinical laboratory sciences, 8(2), 105–144. https://doi.org/10.3109/10408367709151694