Preanalytical errors in biochemistry laboratory

Introduction and Aim: The aim and objective of the study are to quantify and compare preanalytical errors against acceptable international standards using Quality Indicators (QI) at a Biochemistry laboratory and to identify root causes for preanalytical errors and to make recommendations to reduce and prevent preanalytical errors. Materials and Methods: A checklist was developed using Quality indicators given by International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) to quantify preanalytical errors. Data collection was carried out in peak time (9am-11:30 am) and lean time (3pm-4.30pm) for 45 days each. The preanalytical error rate was compared with IFCC and Six sigma standards. Failure mode effect analysis (FMEA) was performed to identify root causes for preanalytical errors. Results: Out of all preanalytical errors, 44.2% were hemolyzed samples (Six sigma level- 3.8), 40.6% were samples with insufficient volume (Six sigma level- 3.9). A comparison made between peak time and lean time showed no significant relationship between preanalytical error rate and workload. Training need was identified after FMEA and training module was developed on venipuncture techniques for nurses and phlebotomists. Conclusion: The overall performance of the laboratory in preanalytical phase was good, Failure mode effect analysis (FMEA) helped to identify major causes of preanalytical errors and to develop measures for the future prevention of preanalytical errors.