There are many common mistakes that occur in pre - analytical and post analytical phases that cause erroneous result. I want to know if there's other new research or updated research regarding this commonly errors that arise in hematology and how can these mistakes be effectively reduced or avoided to guarantee accurate and dependable results for patient diagnosis and treatment?
Source: De la Salle, B. (2019) ‘Pre‐ and postanalytical errors in Haematology’, International Journal of Laboratory Hematology, 41(S1), pp. 170–176. doi:10.1111/ijlh.13007.
According to (Iqbal et al., 2023), laboratory errors can occur at any stage of testing, and identifying these erroneous data can lead to delays in diagnosis and treatment, causing patients to suffer. They conducted a retrospective study on preanalytical errors in the field of hematology, and their observations revealed that patient samples were discarded due to various reasons, including insufficient samples (54.17%) and, less commonly, empty or damaged tubes (0.4%). In the latest study conducted in 2023 on the preanalytical phase, inadequate sample dilution, issues related to phlebotomists, and clotted samples were identified as frequent occurrences. Another study from Hospital Millennium Medical College found that errors begin to manifest when patients are about to provide specimens for testing, with a significant percentage (46-68%) attributed to preanalytical errors, followed by post-analytical phases (19%-47%). The remaining errors are relatively minor but can still impact clinical decision-making for patients. Errors in the post-analytical phase may originate from equipment issues or interfering compounds in the analytical sample, as well as data entry errors (Tadesse et al., 2018). While laboratory errors are inevitable, they can be addressed through coordination and communication with clinicians, especially by providing training on sample collection and proper transportation of specimens.
Source: Iqbal, M.S. et al. (2023) ‘Preanalytical errors in a Hematology Laboratory: An experience from a tertiary care center’, Diagnostics, 13(4), p. 591. doi:10.3390/diagnostics13040591. Tadesse, H. et al. (2018) ‘Errors in the Hematology Laboratory at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia’, BMC Research Notes, 11(1). doi:10.1186/s13104-018-3551-y.
Pre-Analytical Errors are commonly caused by Patient Identification Errors: Mislabeling or mismatching samples with patient information can lead to inaccurate results.
Specimen Collection Errors: Improper specimen collection techniques, such as hemolysis (rupturing of red blood cells), can affect the integrity of the sample.
Contamination: Contamination of blood samples with substances like alcohol or disinfectants can alter test results.
Hemolysis: Mechanical or handling-induced hemolysis can affect parameters like hemoglobin levels and interfere with test accuracy.
Improper Handling and Storage: Blood samples must be handled and stored according to specific guidelines to prevent degradation or alteration of components, such as cellular morphology.
Transportation Delays: Prolonged delays in transporting samples to the laboratory can result in cellular changes, especially for tests requiring fresh samples.
And post analytical are cased by
Data Entry Errors: Mistakes during data entry or transcription can lead to incorrect reporting of results.
Instrument Calibration and Maintenance: Failure to properly calibrate and maintain testing instruments can result in inaccurate measurements.
Interference from Medications or Substances: Certain medications and substances can interfere with hematology tests, causing abnormal results if not properly accounted for.
Quality Control and Quality Assurance Issues: Inadequate quality control procedures and monitoring can affect the reliability of test results.
Misinterpretation: Even after accurate testing, results can be misinterpreted or not properly communicated to healthcare providers.
Sample Mix-Up: After analysis, samples can be mixed up, leading to incorrect reporting of results for specific patients.
Delayed Reporting: Delays in reporting results to healthcare providers can impact patient care, especially in critical situations.
If you are interested, we can collaborate in one research project in this filed. Thanks.
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