Reducing preanalytical laboratory sample errors through educational and technological interventions

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Title: Reducing preanalytical laboratory sample errors through educational and technological interventions
Authors: Lillo, Rosa | Salinas, María | López Garrigós, Maite | Naranjo Santana, Yurena | Gutiérrez, Mercedes | Marín, María Dolores | Miralles, Manuel | Uris Sellés, Joaquín
Research Group/s: Grupo Balmis de Investigación en Salud Comunitaria e Historia de la Ciencia
Center, Department or Service: Universidad de Alicante. Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia
Keywords: Improvement strategies | Laboratory errors | Patient safety | Preanalytical phase | Phlebotomy | Quality in laboratory
Knowledge Area: Enfermería
Issue Date: 2012
Publisher: Clinical Laboratory Publications GmbH
Citation: Clinical Laboratory. 2012, 58 (9-10): 911-917. doi:10.7754/Clin.Lab.2012.111111
Abstract: Background: A correct preanalytical phase procedure is critical to get an adequate sample and consequently to achieve the most reliable laboratory results, promoting patient safety. Continuous laboratory staff changes create the need to establish improvement strategies to reduce the error risk. The objective was to show how the numbers of preanalytical errors related to unsuitable samples in a hospital setting decrease following two improvement strategies related to new technology and educational actions and how their effects were measured by monitoring indicators. Methods: Samples were drawn by the laboratory and other hospital departments’ nurses without previous patient appointment, therefore, prior tube preparation was not available before the phlebotomy. Corrective measures for these activities were established: educational program for nurses and a system of custom labels, which correlate each laboratory test in the Laboratory Information System (LIS) with the corresponding tube. Three phases were defined based on the implementation dates of the improvement actions to be assessed. The set of indicators de-signed to monitor the improvement related to clotted, hemolyzed, insufficient, and uncollected samples. Data were collected and indicators calculated from the LIS using a data warehouse application. Patient satisfaction with re-spect to phlebotomy was also measured annually using a scoring survey. Results: There was a reduction in all types of preanalytical sample errors related to the improvement strategies adopted. The indicators demonstrated that the unavailable, insufficient, and clotted samples decreased between two- and three-fold, whereas hemolysis errors benefited more from these improvement strategies. Patient satisfaction with the laboratory and phlebotomy procedures improved over the past several years as based on the annual satisfaction surveys. Conclusions: The educational program for nursing personnel is relevant and important as can be seen in the de-crease of sample errors and the resulting quality improvement. The custom label system minimizes the potential oversight of forgetting to draw a tube, which happens frequently when operating without appointments, by print-ing the labels according to requested tests. Detection, identification, and monitoring of the error and implement-ing strategies to improve preanalytical quality reduces error numbers and thereby improves patient safety and health system outcomes.
ISSN: 1433-6510
DOI: 10.7754/Clin.Lab.2012.111111
Language: eng
Type: info:eu-repo/semantics/article
Peer Review: si
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Appears in Collections:INV - BISCHA - Artículos de Revistas

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