Pre-analytical Errors in Haematology Laboratory of a Tertiary Care Hospital: A Cross-Sectional Study of northern Pakistan
DOI:
https://doi.org/10.51253/pafmj.v74i1.9402Keywords:
Hemolysed Sample, Lipemic Sample, Pre-analytical errors, Blood, Blood cell count, PakistanAbstract
Objective: To identify the types and frequency of pre-analytical errors in the haematology laboratory and to reduce these preanalytical errors by taking corrective measures.
Study Design: Cross-sectional study.
Place and Duration of Study: Haematology Laboratory of Pak Emirates Military Hospital, Rawalpindi Pakistan, from Mar to Apr 2022 after applying corrective measures, pre-analytical errors were re-analysed from Jun to Jul 2022.
Methodology: The study included all samples received in the haematology laboratory for complete blood count, peripheral blood smear, coagulation profile, and blood malarial parasite. Blood samples were checked for clotted samples, insufficient quantity, diluted samples, hemolysed samples, lipemic samples, and degenerated samples. After that, corrective measures were taken to reduce the pre-analytical errors.
Results: The total number of samples received in the first session was 30,169, and pre-analytical errors were present in 508(0.016%) samples. The most frequent pre-analytical errors were of clotted samples 300(59.1%) followed by quantity not sufficient 168(33.1%), hemolysed samples 68(13.4%), diluted samples 49(9.6%), degenerated samples 22(4.3%) and lipemic samples 18(3.5%). After applying corrective measures, pre-analytical errors were reduced in clotted samples 78(52.7%), quantity not sufficient 39(26.4%), hemolysed samples 14(9.5%), diluted samples 11(7.4%), degenerated samples 5(3.4%) and lipemic samples 4(2.7%) respectively.
Conclusion: This study showed the relative frequency of various pre-analytical errors in a haematology laboratory. It also signifies the implementation of corrective measures for reducing these pre-analytical errors.
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References
Iqbal MS, Tabassum A, Arbaeen AF, Qasem AH, Elshemi AG,
Almasmoum H. Preanalytical Errors in a Hematology Laboratory:
An Experience from a Tertiary Care Center. Diagnostics 2023;
(4): 591. https://doi.org/10.3390/diagnostics13040591
Alavi N, Khan SH, Saadia A, Naeem T. Challenges in
Preanalytical Phase of Laboratory Medicine: Rate of Blood
Sample Nonconformity in a Tertiary Care Hospital. EJIFCC 2020;
(1): 21-27.
Tadesse H, Desta K, Kinde S, Hassen F, Gize A. Errors in the
Hematology Laboratory at St. Paul's Hospital Millennium
Medical College, Addis Ababa, Ethiopia. BMC Res Notes 2018;
(1): 420.https://doi.org/10.1186/s13104-018-3551-y
Kitchen S, Adcock DM, Dauer R, Kristoffersen AH, Lippi G,
Mackie I, et al. International Council for Standardisation in
Haematology (ICSH) recommendations for collection of blood
samples for coagulation testing. Int J Lab Hematol 2021; 43(4):
-580.https://doi.org/10.1111/ijlh.13584
Kamath S, Belurkar S, Reshma G, D’souza SE, Patil A.
Quantification of Pre-Analytical Quality Indicator in a Clinical
Laboratory. Bangladesh J Med Sci 2021; 20(3): 525-529.
Singla P, Parkash AA, Bhattacharjee J. Preanalytical error
occurrence rate in clinical chemistry laboratory of a public
hospital in India. Clin Lab 2011; 57(9-10): 749-752.
Mosha VV, Kabanyana C. The rate of sample rejection and preanalytical errors at KCMC Clinical Laboratory in Moshi,
Kilimanjaro. E Afr Sci 2021; 3(1): 118-124.
https://doi.org/10.24248/EASci-D-20-00005
Yeates RL. An investigation in pre-analytical error in a medium
sized pathology laboratory: frequency, origin, type, and a
proposed intervention: James Cook University; 2016.
Lee NY. Reduction of pre-analytical errors in the clinical
laboratory at the University Hospital of Korea through quality
improvement activities. Clin Biochem 2019; 70: 24-
https://doi.org/10.1016/j.clinbiochem.2019.05.016
Gaur K, Puri V, Shukla S, Sharma S, Suman S, Singh R. Finish
before the start: Analyzing preanalytical sample errors in a
tertiary care hematology laboratory. Indian J Pathol Microbiol
; 63(3): 435-440.https://doi.org/10.4103/IJPM.IJPM_191_19
Singh G, Khalid M, Rahim A, Noor FA. Pre-Analytical Errors in
Haematology and Chemistry at Hayatabad Medical Complex
Peshawar. J Wazir Muhammad Inst Paramed Technol 2022; 2(2):
-35.
Sciacovelli L, Aita A, Chiozza ML. Harmonization of preanalytical quality indicators. Biochem Med 2014; 24(1): 105-113.
Arul P, Pushparaj M, Pandian K, Chennimalai L, Rajendran K,
Selvaraj E, et al. Prevalence and types of preanalytical error in
hematology laboratory of a tertiary care hospital in South India. J
Lab Physicians 2018; 10(2): 237-
https://doi.org/10.4103/JLP.JLP_98_17
Ye Y, Wang W, Zhao H, He F, Zhong K, Yuan S, et al.
Haematology specimen acceptability: a national survey in
Chinese laboratories. Biochem Med 2018; 28(3):
https://doi.org/10.11613/BM.2018.030704
Llopis MA, Bauça JM, Barba N, Álvarez V, Ventura M, Ibarz M, et
al. Spanish Preanalytical Quality Monitoring Program (SEQC), an
overview of 12 years' experience. Clin Chem Lab Med 2017; 55(4):
-538.https://doi.org/10.1515/cclm-2016-0382
Linskens EA, Devreese KMJ. Pre-analytical stability of
coagulation parameters in plasma stored at room temperature. Int
J Lab Hematol 2018; 40(3): 292-303.
https://doi.org/10.1111/ijlh.12784
Pande K, Dahal P, Pokharel L. Identification of types and
frequency of pre-analytical errors in hematology laboratory at a
tertiary hospital of Nepal. J Pathol Nepal 2021; 11(1):1842-
https://doi.org/10.3126/jpn.v11i1.32399
Lippi G, von Meyer A, Cadamuro J, Simundic AM. Blood sample
quality. Diagnosis 2019; 6(1): 25-31.https://doi.org/10.1515/dx2018-0018
Arslan FD, Karakoyun I, Basok BI, Aksit MZ, Celik E, Dogan K, et
al. The Effects of Education and Training Given to Phlebotomists
for Reducing Preanalytical Errors. J Med Biochem 2018; 37(2): 172-
https://doi.org/10.1515/jomb-2017-0045
Berg JE, Ahee P, Berg JD. Variation in phlebotomy techniques in
emergency medicine and the incidence of haemolysed samples.
Ann Clin Biochem 2011; 48(Pt 6): 562-565.
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