2009, Cilt 7, Sayı 2, Sayfa(lar) 049-055 |
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Preanalytical Errors of Specimens Sent from the Emergency Department to the Laboratory |
Tuncay Küme1, Ali Rıza Şişman1, Aygül Özkaya2, Canan Çoker1 |
1Dokuz Eylül Üniversitesi Tıp Fakültesi Biyokimya Anabilim Dalı, İzmir 2Seferihisar Devlet Hastanesi Biyokimya Laboratuvarı, İzmir |
Keywords: Emergency department, laboratory, errors, preanalytic phase, stat test |
Objective: To determine the preanalytical errors in specimens sent from the emergency department
to the laboratory and to evaluate the causes and the consequences.
Material and Methods: All the specimens sent from the emergency department were monitored
during day-time working hours and specimen errors were recorded for four months. Laboratory errors
were classified by test groups, specimen types and causes of specimen rejection. Error percentages in
different steps of the preanalytical phase, error correction ratio and delay times were calculated.
During the same time period, the effects of rotation shift time of intörns and shift changing time on
error quantity were explored.
Results: For 264 erronous specimens, errors occured 4 ± 2 (mean ± SD) times in a day. The frequent
causes were; improper blood level in coagulation tests, hemolysis in biochemical tests and cardiac
markers, clotting in blood gas and complete blood count tests and specimen sent without orders. As
for the calculated error percentages; 26% of th errors occuredin test ordering step, 73% in specimen
collection step and 1% in specimen transport step. 74% of errors were corrected by verbal communication
with the emergency department; however 26% were remained unresolved. The number of errors
increased during rotation shift time of intšrns, which was between 6th and 7th weeks and between
14th and 15th weeks, however number of errors decreased during shift changing time, which was
between 08:30 and 09:30 and between 16:30 and 17:30 hours.
Conclusion: Blood collection by a syringe instead of using vacuated tubes, caused improper blood
level and hemolysis. Also, clot formation due to the insufficient mixing of specimens with anticoagulants
was common error In order to improve test order step regulations in laboratory information
system and for improving specimen collection step modifications in training program of intšrns were
planned.
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