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Preanalytical errors

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https://www.readbyqxmd.com/read/28915106/making-sense-of-a-haemolysis-monitoring-and-reporting-system-a-nationwide-longitudinal-multimethod-study-of-68-australian-laboratory-participant-organisations
#1
Ling Li, Elia Vecellio, Stephanie Gay, Rebecca Lake, Mark Mackay, Leslie Burnett, Douglas Chesher, Stephen Braye, Tony Badrick, Johanna I Westbrook, Andrew Georgiou
BACKGROUND: The key incident monitoring and management systems (KIMMS) quality assurance program monitors incidents in the pre- and postanalytical phases of testing in medical laboratories. Haemolysed specimens have been found to be the most frequent preanalytical error and have major implications for patient care. The aims of this study were to assess the suitability of KIMMS for quality reporting of haemolysis and to devise a meaningful method for reporting and monitoring haemolysis...
September 15, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28893861/adrenal-venous-sampling-for-primary-aldosteronism-laboratory-medicine-best-practice
#2
Gregory Kline, Daniel T Holmes
Primary aldosteronism (PA) is the most common form of secondary hypertension and is critical to identify because when caused by an aldosterone-producing adenoma (APA) or another unilateral form, it is potentially curable, and even when caused by bilateral disease, antihypertensives more specific to PA treatment can be employed (ie, aldosterone antagonists). Identification of unilateral forms is not generally accomplished with imaging because APAs may be small and elude detection, and coincidental identification of a non-functioning incidentaloma contralateral to an APA may lead to removal of an incorrect gland...
September 11, 2017: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28888086/stability-of-routine-biochemical-analytes-in-whole-blood-and-plasma-serum-focus-on-potassium-stability-from-lithium-heparin
#3
Anne Marie Dupuy, Jean Paul Cristol, Bruno Vincent, Anne Sophie Bargnoux, Mickael Mendes, Pascal Philibert, Kadda Klouche, Stéphanie Badiou
BACKGROUND: Blood specimens are transported from clinical departments to the biochemistry laboratory by hospital courier service, sometimes over long distances. The aim of this study was to assess the stability of common biochemical analytes in venous blood under our routine transport conditions and to evaluate analyte stability after prompt or delayed centrifugation. METHODS: We investigated pre- and postanalytical contributions of 32 biochemical analytes in plasma and serum samples from 10 patients (healthy adults and patients from intensive care units)...
September 9, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28804816/preanalytical-issues-in-hemostasis-and-thrombosis-testing
#4
Giuseppe Lippi, Emmanuel J Favaloro
Hemostasis testing is critical to many hemorrhagic and thrombotic disorders, wherein laboratory diagnostics can provide critical information for diagnosis, prognostication, and therapeutic monitoring. Due to this crucial role in modern medicine, hemostasis tests should be carried out at their highest degree of quality, thus encompassing standardization and monitoring of all phases of the testing process. It is now clearly established that the preanalytical phase is the most critical and vulnerable part of the total testing process, since up to 70% of diagnostic errors are due to highly manual activities encompassing patient preparation and collection of biological samples, as well as handling, transportation, preparation and storage of blood specimens...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28694735/what%C3%A2-s-floating-on-my-plasma
#5
Janne Cadamuro, Helmut Wiedemann, Thomas K Felder, Cornelia Mrazek, Ulrike Kipman, Oberkofler Hannes, Elisabeth Haschke-Becher
We report on a preanalytical issue we encountered during routine clinical chemistry analyses, potentially leading to deviated analysis results and believe that it might help other laboratories to overcome similar problems. In a heparin-gel tube we measured an implausible glucose value of 0.06 mmol/L. Re-measurement of the same sample resulted in a glucose value of 5.4 mmol/L. After excluding an analytical error, we inspected the sample closer and found a white material as well as fatty droplets floating on the surface of the plasma tube...
June 15, 2017: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
https://www.readbyqxmd.com/read/28680348/preanalytical-nonconformity-management-regarding-primary-tube-mixing-in-brazil
#6
Gabriel Lima-Oliveira, Gian Cesare Guidi, Andre Valpassos Pacifici Guimaraes, Jose Abol Correa, Giuseppe Lippi
BACKGROUND: The multifaceted clinical laboratory process is divided in three essential phases: the preanalytical, analytical and postanalytical phase. Problems emerging from the preanalytical phase are responsible for more than 60% of laboratory errors. This report is aimed at highlighting and discussing nonconformity (e.g., nonstandardized procedures) in primary blood tube mixing immediately after blood collection by venipuncture with evacuated tube systems. METHODS: From January 2015 to December 2015, fifty different laboratory quality managers from Brazil were contacted to request their internal audit reports on nonconformity regarding primary blood tube mixing immediately after blood collection by venipuncture performed using evacuated tube systems...
January 2017: Journal of Medical Biochemistry
https://www.readbyqxmd.com/read/28593925/intensive-educational-efforts-combined-with-external-quality-assessment-improve-the-preanalytical-phase-in-general-practitioner-offices-and-nursing-homes
#7
Una Ørvim Sølvik, Wenche Iren Bjelkarøy, Kari van den Berg, Anne Lise Saga, Helle Borgstrøm Hager, Sverre Sandberg
BACKGROUND: Errors in the preanalytical phase in clinical laboratories affect patient safety. The aim of this study was to evaluate the effect of intensive educational efforts together with external quality assessment (EQA) of the preanalytical phase from 2013 to 2015 to improve patient identification in primary health care in Norway. In addition, routines for venous and capillary blood sampling were investigated. METHODS: A preanalytical EQA was circulated in 2013 by the Norwegian Quality Improvement of Laboratory Examinations (Noklus) to general practitioner offices and nursing homes (n=2000) to obtain information about important issues to focus on before launching an intensive educational program with courses, posters and visits in 2013-2015...
May 5, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28502727/concordance-between-research-sequencing-and-clinical-pharmacogenetic-genotyping-in-the-emerge-pgx-study
#8
Laura J Rasmussen-Torvik, Berta Almoguera, Kimberly F Doheny, Robert R Freimuth, Adam S Gordon, Hakon Hakonarson, Jared B Hawkins, Ammar Husami, Lynn C Ivacic, Iftikhar J Kullo, Michael D Linderman, Teri A Manolio, Aniwaa Owusu Obeng, Renata Pellegrino, Cynthia A Prows, Marylyn D Ritchie, Maureen E Smith, Sarah C Stallings, Wendy A Wolf, Kejian Zhang, Stuart A Scott
There has been extensive debate about both the necessity of orthogonal confirmation of next-generation sequencing (NGS) results in Clinical Laboratory Improvement Amendments-approved laboratories and return of research NGS results to participants enrolled in research studies. In eMERGE-PGx, subjects underwent research NGS using PGRNseq and orthogonal targeted genotyping in clinical laboratories, which prompted a comparison of genotyping results between platforms. Concordance (percentage agreement) was reported for 4077 samples tested across nine combinations of research and clinical laboratories...
July 2017: Journal of Molecular Diagnostics: JMD
https://www.readbyqxmd.com/read/28471194/-lactate-dehydrogenase-old-tumour-marker-in-the-light-of-current-knowledge-and-preanalytic-conditions
#9
K Greplová, I Selingerová, D Valík, K Pilatova, M Češková, L Zdražilová Dubská
With the development and subsequent clinical applications of anticancer immuno-and angiomodulatory therapies and expanded knowledge on significance of tumor microenvironment for disease prognosis and treatment outcome, a classical blood analyte, lactate dehydrogenase (LDH), gains in importance as a tumor marker reflecting to some extent immunosupressive and angiogenic tumour milieu. Physical extravascular hemolysis due to complicated or inaccurate blood sampling interferes strongly with quantification of LDH in serum/plasma samples...
2017: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/28392739/preanalytical-investigations-of-phlebotomy-methodological-aspects-pitfalls-and-recommendations
#10
REVIEW
Cristiano Ialongo, Sergio Bernardini
Phlebotomy is often addressed as a crucial process in the pre-analytical phase, in which a large part of laboratory errors take place, but to date there is not yet a consolidated methodological paradigm. Seeking literature, we found 36 suitable investigations issued between 1996 and 2016 (April) dealing with the investigation of pre-analytical factors related to phlebotomy. We found that the largest part of studies had a cohort of healthy volunteers (22/36) or outpatients (11/36), with the former group showing a significantly smaller median sample size (N = 20, IQR: 17...
February 15, 2017: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
https://www.readbyqxmd.com/read/28356887/pre-test-and-post-test-applications-to-shape-the-education-of-phlebotomists-in-a-quality-management-program-an-experience-in-a-training-hospital
#11
Güzin Aykal, Mustafa Keşapli, Özgür Aydin, Hatice Esen, Ayşenur Yeğin, Faruk Güngör, Necat Yilmaz
BACKGROUND: After the introduction of modern laboratory instruments and information systems, preanalytic phase is the new field of battle. Errors in preanalytical phase account for approximately half of total errors in clinical laboratory. The objective of this study was to share an experience of an education program that was believed to be successful in decreasing the number of rejected samples received from the Emergency Department (ED). METHODS: An education program about laboratory procedures, quality requirements in the laboratory, patient and health-care worker safety was planned by the quality team to be performed on 36 people who were responsible for sample collection in the ED...
September 2016: Journal of Medical Biochemistry
https://www.readbyqxmd.com/read/28340232/a-proposed-set-of-metrics-to-reduce-patient-safety-risk-from-within-the-anatomic-pathology-laboratory
#12
Peter Banks, Richard Brown, Alex Laslowski, Yvonne Daniels, Phil Branton, John Carpenter, Richard Zarbo, Ramses Forsyth, Yan-Hui Liu, Shane Kohl, Joachim Diebold, Shinobu Masuda, Tim Plummer, Eslie Dennis
Background: Anatomic pathology laboratory workflow consists of 3 major specimen handling processes. Among the workflow are preanalytic, analytic, and postanalytic phases that contain multistep subprocesses with great impact on patient care. A worldwide representation of experts came together to create a system of metrics, as a basis for laboratories worldwide, to help them evaluate and improve specimen handling to reduce patient safety risk. Method: Members of the Initiative for Anatomic Pathology Laboratory Patient Safety (IAPLPS) pooled their extensive expertise to generate a list of metrics highlighting processes with high and low risk for adverse patient outcomes...
May 1, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28316435/delta-check-for-blood-groups-a-step-ahead-in-blood-safety
#13
Raj Nath Makroo, Aakanksha Bhatia
BACKGROUND: Blood grouping is the single most important test performed by each and every transfusion service. A blood group error has a potential for causing severe life-threatening complications. A number of process strategies have been adopted at various institutions to prevent the occurrence of errors at the time of phlebotomy, pretransfusion testing, and blood administration. A delta check is one such quality control tool that involves the comparison of laboratory test results with results obtained on previous samples from the same patient...
January 2017: Asian Journal of Transfusion Science
https://www.readbyqxmd.com/read/28242283/blood-venous-sample-collection-recommendations-overview-and-a-checklist-to-improve-quality
#14
REVIEW
Davide Giavarina, Giuseppe Lippi
The extra-analytical phases of the total testing process have substantial impact on managed care, as well as an inherent high risk of vulnerability to errors which is often greater than that of the analytical phase. The collection of biological samples is a crucial preanalytical activity. Problems or errors occurring shortly before, or soon after, this preanalytical step may impair sample quality and characteristics, or else modify the final results of testing. The standardization of fasting requirements, rest, patient position and psychological state of the patient are therefore crucial for mitigating the impact of preanalytical variability...
July 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28178899/recognizing-and-reducing-analytical-errors-and-sources-of-variation-in-clinical-pathology-data-in-safety-assessment-studies
#15
A E Schultze, A R Irizarry
Veterinary clinical pathologists are well positioned via education and training to assist in investigations of unexpected results or increased variation in clinical pathology data. Errors in testing and unexpected variability in clinical pathology data are sometimes referred to as "laboratory errors." These alterations may occur in the preanalytical, analytical, or postanalytical phases of studies. Most of the errors or variability in clinical pathology data occur in the preanalytical or postanalytical phases...
February 2017: Toxicologic Pathology
https://www.readbyqxmd.com/read/28164516/hil-interferences-on-three-hemostasis-analyzers-and-contribution-of-a-preanalytical-module-for-routine-coagulation-assays
#16
Carole Nagant, Laurence Rozen, Anne Demulder
BACKGROUND: Preanalytical issues are a major part of routine coagulation laboratory errors. Automation in detection of preanalytical problems, including hemolysis, icterus and lipemia (HIL), improper tube fill volume, and undue clotting, has recently been implemented on specific hemostasis instruments. The aim of this study was to assess the added value of a new preanalytical module integrated into hemostasis analyzers compared to visual inspection of samples. METHODS: The detection of preanalytical issues was performed by visual or manual inspection of the samples and by the new preanalytical module integrated on the ACL TOP 550...
October 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28163015/a-pragmatic-approach-to-sample-acceptance-and-rejection
#17
Janne Cadamuro, Ana-Maria Simundic, Eva Ajzner, Sverre Sandberg
Sample rejection due to preanalytical errors is very common in many medical laboratories worldwide, though the decision when and how to refrain from analyzing such samples is handled very heterogeneously. As a rational, it is mostly stated that it is done to prevent the patient from being harmed by wrong medical decisions based on such values. But when thinking of the consequences of laboratory results instead of their quality being important per se, the rejection of preanalytically altered samples might be harming the patient by the need of re-collection and timely delay...
July 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28125403/innovative-software-for-recording-preanalytical-errors-in-accord-with-the-ifcc-quality-indicators
#18
Giuseppe Lippi, Laura Sciacovelli, Ana-Maria Simundic, Mario Plebani
No abstract text is available yet for this article.
March 1, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28079593/improving-the-clinic-laboratory-interface-in-the-context-of-hiv-diagnosis-treatment-and-monitoring
#19
REVIEW
Timothy Johan Tucker, Peter Tsakani Manyike
PURPOSE OF REVIEW: Laboratory support is central to clinical medicine. The present review focuses on the health systems strengthening needs of the clinic-laboratory-interface (CLI) in developing countries within the context of HIV diagnosis, treatment, and monitoring. RECENT FINDINGS: Although significant improvements have been made in reducing error rates in the analytical phase of pathology services within laboratories, there remain substantial deficits in both the preanalytic and postanalytic phases of the entire value chain that require strengthening...
March 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28069401/analytes-related-to-erythrocyte-metabolism-are-reliable-biomarkers-for-preanalytical-error-due-to-delayed-plasma-processing-in-metabolomics-studies
#20
Mahim Jain, Adam D Kennedy, Sarah H Elsea, Marcus J Miller
BACKGROUND: Delaying plasma separation after phlebotomy (processing delay) can cause perturbations of numerous small molecule analytes. This poses a major challenge to the clinical application of metabolomics analyses. In this study, we further define the analyte changes that occur during processing delays and generate a model for the post hoc detection of this preanalytical error. METHODS: Using an untargeted metabolomics platform we analyzed EDTA-preserved plasma specimens harvested after processing delays lasting from minutes to days...
March 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
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