engleski

Assessment of pre-analytical quality indicators with sigma-metrics

Retrospective analysis of data collected in 2014 regarding unfilled required data in the request- form, sample misidentification and recollection. Misidentification errors refer to unlabeled or wrong labeled sample container. Recollection was needed for inappropriate sample quality caused by extreme hemolysis, clotting or inappropriate sample-anticoagulant volume ratio. Laboratory is organized as multisite with 3 spaciously separated laboratories (1 km (B) and 4 km (C) distance from the main premises (A)) differing in laboratory and hospital information management system (LIS and HIS) or procedures for requesting laboratory services. Pareto analysis was used to identify the most prevalent request-form errors. Sigma is calculated by the use of Westgards´ six- sigma calculator. Data were analysed by Medcalc Statistical software. From the total of 424027 requests unfilled data on request-form were notified in 49396 cases (11.6% ; sigma 2.7) with difference between sites (P<0.0001): A (13.0% ; sigma 2.8), B (6.4% ; sigma 2.9), C (0.3% ; sigma 4.3). The most critical request-form errors: patient name (C: >6.0 ; A: 5.1 ; B: 4.5) ; date of birth (C >6.0 ; B: 5.0 ; A: 4.3), test ordered (B: >6.0 ; A: 5.3 ; C: 4.6), had sigma >4.0 or close to quality goal of 5.0. Misidentified were 121/424027 samples (0.03% ; sigma 5.0) and B laboratory recorded the highest rate (0.14% ; sigma 4.5) in comparison with C (0.01% ; P<0.0001 ; sigma 5.2) and A (0.02% ; P<0.0001 ; sigma 5.1). Recollection was indicated in 4868/424027 cases (1.1% ; sigma 3.8) with difference between sites (P<0.0001): A (1.0% ; sigma 3.9), B (1.8% ; sigma 3.6), C (2.2%, sigma 3.5). The observed samples quality required for reliable analysis is not good to reach sigma 5.0 and laboratory should pay more attention to find a way to improve it. The main causes for 80% of all request-form errors were site specific and dependent on LIS and HIS used.

indikatori kvalitete; sigmametrija

nije evidentirano