Authors :
Dr. Sushma BJ; Aayush Mahajan
Volume/Issue :
Volume 10 - 2025, Issue 1 - January
Google Scholar :
https://tinyurl.com/5fephaz6
Scribd :
https://tinyurl.com/24cvtjss
DOI :
https://doi.org/10.5281/zenodo.14836649
Abstract :
Background:
Pre-analytical errors are a significant source of inaccuracies in clinical biochemistry laboratories, contributing to
approximately 60-70% of total laboratory errors. These errors arise during the pre-examination phase, which spans from
test ordering to sample analysis. Given the potential impact on diagnostic outcomes, understanding and mitigating these
errors is critical to improving laboratory quality.
Objectives:
The study aims to enumerate and analyze the frequency of pre-analytical errors in a Clinical Biochemistry laboratory,
with a particular focus on assessing the effect of hemolysis on blood glucose levels.
Materials and Methods:
Data were collected across various hospital departments, and the occurrence of pre-analytical errors was assessed. The
analysis focused on the impact of hemolysis on test results, particularly blood glucose measurements.
Results:
The findings reveal significant variation in the frequency of pre-analytical errors across different clinical departments.
The Inpatient Department accounted for the highest proportion of errors (50.36%), followed by the Critical Care Medicine
department at 43.13%. In contrast, lower rates of errors were observed in the Emergency Department (3.61%) and
Outpatient Department (2.89%). Hemolysis was identified as the most prevalent error type, followed by issues such as
inadequate sample volume, improper tube selection, labeling errors, and clot formation in serum samples. These findings
underscore that pre-analytical errors are particularly common in inpatient and critical care settings, suggesting the need
for targeted interventions in these areas.
Conclusion:
The study highlights the significant role of pre-analytical factors in shaping laboratory test outcomes. Hemolysis,
inadequate sample volume, and other procedural errors were found to be the most frequent contributors to inaccurate
results. The research emphasizes the importance of adhering to standardized protocols and implementing quality control
measures to reduce errors, enhance the accuracy of laboratory testing, and ultimately improve patient care.
Keywords :
Pre-Analytical Errors, Clinical Biochemistry Laboratory, Hemolysis and Quality Control.
References :
- Medical laboratories - Reduction of error through risk management and continual improvement (ISO/TS 22367:2008, including Cor 1:2009). Published January 2010. Accessed on 21 Nov 2021.
- Dereen Najat; Prevalence of PreAnalytical Errors in Clinical Chemistry Diagnostic Labs in Sulaimani City of Iraqi Kurdistan. PLoS One. 2017; 12(1).
- Dikmen ZG, Pinar A, Akbiyik F. Specimen rejection in laboratory medicine: necessary for patient safety? Biochem Med (Zagreb). 2015;25:377–85.
- Bonini P, Plebani M, Ceriotti F, Rubboli F. Errors in laboratory medicine. Clin Chem 2002;48:691‑8.
- Howanitz PJ. Errors in laboratory medicine: Practical lessons to improve patient safety. Arch Pathol Lab Med 2005; 129:1252‑61.
- Sushma BJ, Shrikant C. Study on “Pre-analytical Errors in a Clinical Biochemistry Laboratory”: The Hidden Flaws in Total Testing. Biochem Anal Biochem 2019 8:374. doi: 10.35248/2161-1009.19.8.374.
- Santosh Kumar, et. al., Preanalytical Errors in Clinical Biochemistry Laboratory, International Journal of Contemporary Medicine-July-December 2020, Vol.8, No. 2 29-31.
- Koseoglu M, Hur A, Atay A, Cuhadar S. Effects of hemolysis interference on routine biochemistry parameters. Biochem Med. 2011; 21:79-85.
- Alcantara JC, Alharbi B, Almotairi Y, Alam MJ, Muddathir ARM, Alshaghdali K. Analysis of preanalytical errors in a clinical chemistry laboratory: A 2-year study. Medicine (Baltimore). 2022 Jul 8;101(27):e29853.
- Zaini RG, Dahlawi HA, Siddiqi A. Identification of the types and frequencies of pre-analytical errors in the clinical biochemistry laboratory: 1-year study at Hera’a General Hospital. Arch Med. 2016;8:4.
Background:
Pre-analytical errors are a significant source of inaccuracies in clinical biochemistry laboratories, contributing to
approximately 60-70% of total laboratory errors. These errors arise during the pre-examination phase, which spans from
test ordering to sample analysis. Given the potential impact on diagnostic outcomes, understanding and mitigating these
errors is critical to improving laboratory quality.
Objectives:
The study aims to enumerate and analyze the frequency of pre-analytical errors in a Clinical Biochemistry laboratory,
with a particular focus on assessing the effect of hemolysis on blood glucose levels.
Materials and Methods:
Data were collected across various hospital departments, and the occurrence of pre-analytical errors was assessed. The
analysis focused on the impact of hemolysis on test results, particularly blood glucose measurements.
Results:
The findings reveal significant variation in the frequency of pre-analytical errors across different clinical departments.
The Inpatient Department accounted for the highest proportion of errors (50.36%), followed by the Critical Care Medicine
department at 43.13%. In contrast, lower rates of errors were observed in the Emergency Department (3.61%) and
Outpatient Department (2.89%). Hemolysis was identified as the most prevalent error type, followed by issues such as
inadequate sample volume, improper tube selection, labeling errors, and clot formation in serum samples. These findings
underscore that pre-analytical errors are particularly common in inpatient and critical care settings, suggesting the need
for targeted interventions in these areas.
Conclusion:
The study highlights the significant role of pre-analytical factors in shaping laboratory test outcomes. Hemolysis,
inadequate sample volume, and other procedural errors were found to be the most frequent contributors to inaccurate
results. The research emphasizes the importance of adhering to standardized protocols and implementing quality control
measures to reduce errors, enhance the accuracy of laboratory testing, and ultimately improve patient care.
Keywords :
Pre-Analytical Errors, Clinical Biochemistry Laboratory, Hemolysis and Quality Control.
