engleski

AUDITING THE PREANALYTICAL PHASE: EVALUATION OF HEMOLYSIS IN SAMPLES DRAWN BY HOSPITAL VERSUS LABORATORY STAFF

BACKGROUND: The preanalytical phase is a complex and dynamic error-prone process. In vitro haemolysis remains the leading cause of unsuitable specimens and is one of the most important quality indicator of the preanalytical phase in medical biochemistry laboratories. The aim of the study was to evaluate factors attributed to hemolysis in serum samples in order to reduced the number of the rejected samples and improve the efficient patients treatment. METHODS: A retrospective analysis of preanalytical quality indicators in medical biochemistry laboratory accredited according to ISO 15189 norm for a period of 1 year has been carried out to summarize data regarding the frequency of the main factors affecting the preanalytical quality of serum samples. In addition, the analysis and evaluation of Preanalytical Phase was provided by BD Diagnostics – Preanalytical Systems. The information were generated by the BD LCS™ Preanalytical Q.C. RESULTS: During the data collection period 533 (0, 54%) samples from 97975 patients were found unsuitable for furter processing. Rejections arose as a result of the following reasons: 285 specimens (53, 5%) were rejected due to hemolysis ; 108 (20, 3%) due to clotting, 60 (11, 3%) had insufficient sample quantity ; 29 (5, 4%) were specimens without proper identifications ; 22 (4, 1%) were specimens with inadequate transportation conditions and 29 (5, 4%) were requested but not collected specimens. Hemolysis was considerably more frequent in the chemistry than coagulation specimens (255 vs.30 samples). According to the BD Diagnostics – Preanalytical Systems Q.C results the frequency of hemolysis was significantlly higher in samples drawn by hospital versus laboratory phlebotomists, and in samples coming from the Emergency Department (ED) than in the non- urgent ward. CONCLUSIONS: The increased number of hemolysed serum and plasma samples that occurs in the hospital wards and ED may be a results of drawing blood through intravenous catheters. The ED staff often draw blood samples from an intravenous catheter at the time a new intravenous line is placed to reduce the need to expose the patients to two separate needle sticks. Additional actions and educations were required to continue decreasing hemolysis of blood samples drawn by hospital staff.

PREANALYTICAL PHASE; HEMOLYSIS

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