engleski

Preanalytical Variation

The annual incidence of premature patient deaths associated with some form of preventable medical error in the USA has been estimated to be 98, 000/year. More recent data indicate that the actual mortality caused by preventable medical errors might even be 4-fold higher. Laboratory errors significantly contribute to the overall error frequency in healthcare. They can lead to diagnostic errors (i.e. missed diagnosis, misdiagnosis and delayed diagnosis) and consequent patient harm, and increasedhealthcare expenditure. The preanalytical phase is recognized as the most vulnerable part of the total testing process and it accounts for two thirds of all laboratory errors and may be attributed to various causes. Many preanalytical steps are performed outside the laboratory and are not under the direct supervision of laboratory staff. Furthermore, many individuals are involved in various pre-analytical steps and those individuals have different levels of education and professional background. Finally, safe practice standards for many activities and procedures are: i) either not available, or ii) are available but are not evidence-based, or iii) there is low level of compliance with those standards. The ISO 15189 accreditation standard clearly defines that medical laboratories are responsible for the management and quality of the pre-examination phase. It is the role of the laboratorian to assure that the right sample is taken from the right patient, at the right time, and that correct test results are provided to the requesting physician in a timely manner. If the quality of the specimen is compromized to a degree where the expected effect is larger than the allowable error, causing clinically significant bias, the sample should be rejected for analysis. The guiding principle should be: ‘No result is always better than a bad result’.

preanalytical variation

nije evidentirano