Pre-analytical Laboratory Errors in the Department of Chemical Pathology at a Tertiary Care Hospital
Keywords:
Clinical Chemistry, Laboratory Errors, Lipemic Samples, Pre-Analytical Error, Sample Requests.Abstract
Objective: To determine the frequency and types of pre-analytical laboratory errors in the Department of Chemical Pathology at a tertiary care hospital in Pakistan.
Study Design: Prospective cross-sectional study.
Place and Duration of Study: This study was conducted at the Department of Chemical Pathology & Endocrinology, Fauji Foundation Hospital, Rawalpindi, from December 1, 2023, to March 1, 2024.
Materials and Methods: Following approval of the study protocol by the Institutional Review Board (IRB), data on laboratory requests (n=68,899) was assessed through the Laboratory Information System (LIS) in the Department of Chemical Pathology and Endocrinology. The study assessed all laboratory requests received during the study period to determine the prevalence of errors. Samples received from the Inpatient Department (IPD) and Outpatient Department (OPD) were examined physically and cross-checked for any specimen-related discrepancy against the records in the LIS.
Results: Of the total requests (n=68,899), 34,422 (49.96%) were received in the morning, 23,729 (34.44%) in the evening, and 10,748 (15.60%) at night. The overall incidence of pre-analytical errors was 5.53% (n=3,808). The most frequent errors were hemolyzed samples (52.65%) and lipemic samples (36.97%). Other errors included insufficient specimen quantity (6.80%), labeling errors (2.02%), and inadequate patient information (1.58%). From the total 68,899 requests, 41,340 were received from wards (IPD) and 27,559 from the OPD. The
error rate was significantly higher in the IPD (6.75%, n=2,790) compared to the OPD (3.69%, n=1,018) (p <0.001). A statistically significant difference was also observed in error frequencies between morning and evening sample requests (p ≤ 0.05).
Conclusion: This study highlights the burden of pre-analytical errors in clinical chemistry samples and underscores the need for improved specimen collection and handling practices. Continuous training and strict adherence to protocols are essential to minimize these errors.
