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Quality Audit on Venous Blood Sample Processing in Laboratories of Governmental Hospitals in Gamo Gofa Zone, South Ethiopia

Published: 2 April 2013
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Abstract

Back ground: Pre-analytical activities persist to pose significant amount of uncertainties in clinical laboratories causing adverse impacts on patient health and the entire healthcare system. Venous blood sample (VBS) processing that has many error prone activities is one of the pre-analytical procedures performed in the laboratory. The objective of our survey was to identify, in Ethiopian Hospital laboratory set-up, the major activities in the processing of VBS in which undesirable practices that may result in errors are executed. Methods: We have conducted institution based cross-sectional survey sup-plemented with non-participatory type observational study from February 2012 to September 2012 in laboratories of three governmental hospitals of Gamo Gofa zone, Southern Ethiopia. Pre-tested questionnaire and check list were used for data collection. Analysis of the data was performed using Medcalc® version 12.1.4 software. Results: A total of 19 laboratory professionals working in the three governmental hospitals were included in this survey. The activities possessing highest proportions of undesirable practices were related to establishment and adherence to serum/plasma/whole blood rejection criteria, measures taken when produced serum/plasma is too small for analysis, speed and duration of centrifugation. Low proportion of undesirable practices were found in activities related to capping test tubes before centrifugation, maximum allowed time before analysis of unpreserved serum/plasma/whole blood samples and balancing during centrifugation. None of the socio-demographic and background information of participants we assessed was associated with undesirability of VBS processing activities. Conclusion: From this study, we concluded that the VBS processing in the laboratories involved many undesirable practices that might lead to erroneous results. We identified that the gearing problem to the undesirable practices was absence of laboratory documents regarding VBS processing activities. Therefore, establishment and strict adherence to laboratory documents for every activity in VBS processing by every laboratory personnel would avoid many of the unde-sirable practices.

Published in Science Journal of Clinical Medicine (Volume 2, Issue 2)
DOI 10.11648/j.sjcm.20130202.14
Page(s) 52-57
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2013. Published by Science Publishing Group

Keywords

Venous Blood Sample Processing, Undesirable Practice, Pre-Analytical Error, Standard Operating Procedure

References
[1] LLopis MA, Alvarez V, Martínez-Brú C, Gómez R, Barba N, Ibarz M, Cortés M, Ventura M, Alsina MJ. Quality Assurance in the Preanalytical Phase. The Spanish Society of Clinical Chemistry Committee for the extra-analytical quality assessment, Spain. 2012: 185-204.
[2] Bonini P, Plebani M, Ceriotti F, Rubboli F. Errors in Laboratory Medicine. Clin Chem 2002; 48 (5): 691–698.
[3] Goswami B, Singh B, Chawla R, Mallika V. Evaluation of errors in a clinical laboratory: a one-year experience. Clin Chem Lab Med 2010; 48 (1): 63–66.
[4] Plebani M. Errors in clinical laboratories or errors in laboratory medicine? Clin Chem Lab Med 2006; 44 (6): 750–759.
[5] Rattan A, Lippi G. Frequency and type of preanalytical errors in a laboratory medicine department in India. Clin Chem Lab Med 2008; 46 (11): 1657–1659.
[6] Nigam PK. Preanalytical Errors: Some Common Errors in Blood Specimen Collection for Routine Investigations in Hospital Patients. Journal of Clinical and Diagnostic Research 2011: 5 (3): 659-661.
[7] Clinical and Laboratory Standards Institute (CLSI). Procedures for the Handling and Processing of Blood Specimens; Approved Guideline—Forth Edition. CLSI document H18-A4 (ISBN 1-56238-724-3) 2010. CLSI, 940 West Valley Road, Suite 1400, Wayne, Pennsylvania 19087-1898 USA.
[8] Livesey JH, Ellis MJ, Evans MJ. Pre-analytical requirements. Clin Biochem Rev August 2008; 29 Suppl (i): S11-S15.
[9] Morris AJ, Smith LK, Mirrett S, Reller LB. Cost and time savings following introduction of rejection criteria for clinical specimens. J. CLIN. MICROBIOL. 1996; 34 (2): 355-357.
[10] Morris AJ, Wilson ML, Reller LB. Application of Rejection Criteria for Stool Ovum and Parasite Examinations. J. CLIN. MICROBIOL. 1992; 30 (12): 3213-3216.
[11] Boyanton BL. Jr, Blick KE, Stability studies of twenty four analytes in human plasma and serum. Clin Chem 2002; 48: 2242-2247.
[12] Zhang DJ, Elswick RK, Miller WG, Bailey JL. Effect of serum-clot contact time on clinical chemistry laboratory results. Clin Chem 1998; 44 (6): 1325-1333.
[13] Clinical and Laboratory Standards Institute (CLSI). Procedures for the Collection of Diagnostic Blood Specimens by Venipuncture; Approved Standard. CLSI document H3-A6 (ISBN 1-56238-650-6) 2007. CLSI, 940 West Valley Road, Suite 1400, Wayne, Pennsylvania 19087-1898 USA.
[14] Rattan A, Lippi G. Frequency and type of preanalytical errors in a laboratory medicine department in India. Clin Chem Lab Med 2008; 46 (11): 1657–1659.
[15] Nigam PK. Preanalytical Errors: Some Common Errors in Blood Specimen Collection for Routine Investigations in Hospital Patients. Journal of Clinical and Diagnostic Research 2011: 5 (3): 659-661.
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  • APA Style

    Mulugeta Melkie, Abel Girma, Tsegaye Tsalla. (2013). Quality Audit on Venous Blood Sample Processing in Laboratories of Governmental Hospitals in Gamo Gofa Zone, South Ethiopia. Science Journal of Clinical Medicine, 2(2), 52-57. https://doi.org/10.11648/j.sjcm.20130202.14

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    ACS Style

    Mulugeta Melkie; Abel Girma; Tsegaye Tsalla. Quality Audit on Venous Blood Sample Processing in Laboratories of Governmental Hospitals in Gamo Gofa Zone, South Ethiopia. Sci. J. Clin. Med. 2013, 2(2), 52-57. doi: 10.11648/j.sjcm.20130202.14

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    AMA Style

    Mulugeta Melkie, Abel Girma, Tsegaye Tsalla. Quality Audit on Venous Blood Sample Processing in Laboratories of Governmental Hospitals in Gamo Gofa Zone, South Ethiopia. Sci J Clin Med. 2013;2(2):52-57. doi: 10.11648/j.sjcm.20130202.14

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  • @article{10.11648/j.sjcm.20130202.14,
      author = {Mulugeta Melkie and Abel Girma and Tsegaye Tsalla},
      title = {Quality Audit on Venous Blood Sample Processing in Laboratories of Governmental Hospitals in Gamo Gofa Zone, South Ethiopia},
      journal = {Science Journal of Clinical Medicine},
      volume = {2},
      number = {2},
      pages = {52-57},
      doi = {10.11648/j.sjcm.20130202.14},
      url = {https://doi.org/10.11648/j.sjcm.20130202.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjcm.20130202.14},
      abstract = {Back ground: Pre-analytical activities persist to pose significant amount of uncertainties in clinical laboratories causing adverse impacts on patient health and the entire healthcare system. Venous blood sample (VBS) processing that has many error prone activities is one of the pre-analytical procedures performed in the laboratory. The objective of our survey was to identify, in Ethiopian Hospital laboratory set-up, the major activities in the processing of VBS in which undesirable practices that may result in errors are executed. Methods: We have conducted institution based cross-sectional survey sup-plemented with non-participatory type observational study from February 2012 to September 2012 in laboratories of three governmental hospitals of Gamo Gofa zone, Southern Ethiopia. Pre-tested questionnaire and check list were used for data collection. Analysis of the data was performed using Medcalc® version 12.1.4 software. Results: A total of 19 laboratory professionals working in the three governmental hospitals were included in this survey. The activities possessing highest proportions of undesirable practices were related to establishment and adherence to serum/plasma/whole blood rejection criteria, measures taken when produced serum/plasma is too small for analysis, speed and duration of centrifugation. Low proportion of undesirable practices were found in activities related to capping test tubes before centrifugation, maximum allowed time before analysis of unpreserved serum/plasma/whole blood samples and balancing during centrifugation. None of the socio-demographic and background information of participants we assessed was associated with undesirability of VBS processing activities. Conclusion: From this study, we concluded that the VBS processing in the laboratories involved many undesirable practices that might lead to erroneous results. We identified that the gearing problem to the undesirable practices was absence of laboratory documents regarding VBS processing activities. Therefore, establishment and strict adherence to laboratory documents for every activity in VBS processing by every laboratory personnel would avoid many of the unde-sirable practices.},
     year = {2013}
    }
    

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  • TY  - JOUR
    T1  - Quality Audit on Venous Blood Sample Processing in Laboratories of Governmental Hospitals in Gamo Gofa Zone, South Ethiopia
    AU  - Mulugeta Melkie
    AU  - Abel Girma
    AU  - Tsegaye Tsalla
    Y1  - 2013/04/02
    PY  - 2013
    N1  - https://doi.org/10.11648/j.sjcm.20130202.14
    DO  - 10.11648/j.sjcm.20130202.14
    T2  - Science Journal of Clinical Medicine
    JF  - Science Journal of Clinical Medicine
    JO  - Science Journal of Clinical Medicine
    SP  - 52
    EP  - 57
    PB  - Science Publishing Group
    SN  - 2327-2732
    UR  - https://doi.org/10.11648/j.sjcm.20130202.14
    AB  - Back ground: Pre-analytical activities persist to pose significant amount of uncertainties in clinical laboratories causing adverse impacts on patient health and the entire healthcare system. Venous blood sample (VBS) processing that has many error prone activities is one of the pre-analytical procedures performed in the laboratory. The objective of our survey was to identify, in Ethiopian Hospital laboratory set-up, the major activities in the processing of VBS in which undesirable practices that may result in errors are executed. Methods: We have conducted institution based cross-sectional survey sup-plemented with non-participatory type observational study from February 2012 to September 2012 in laboratories of three governmental hospitals of Gamo Gofa zone, Southern Ethiopia. Pre-tested questionnaire and check list were used for data collection. Analysis of the data was performed using Medcalc® version 12.1.4 software. Results: A total of 19 laboratory professionals working in the three governmental hospitals were included in this survey. The activities possessing highest proportions of undesirable practices were related to establishment and adherence to serum/plasma/whole blood rejection criteria, measures taken when produced serum/plasma is too small for analysis, speed and duration of centrifugation. Low proportion of undesirable practices were found in activities related to capping test tubes before centrifugation, maximum allowed time before analysis of unpreserved serum/plasma/whole blood samples and balancing during centrifugation. None of the socio-demographic and background information of participants we assessed was associated with undesirability of VBS processing activities. Conclusion: From this study, we concluded that the VBS processing in the laboratories involved many undesirable practices that might lead to erroneous results. We identified that the gearing problem to the undesirable practices was absence of laboratory documents regarding VBS processing activities. Therefore, establishment and strict adherence to laboratory documents for every activity in VBS processing by every laboratory personnel would avoid many of the unde-sirable practices.
    VL  - 2
    IS  - 2
    ER  - 

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Author Information
  • Department of Medical Laboratory Science, Arbaminch University, Arbaminch, Ethiopia

  • Department of Medical Laboratory Science, Arbaminch University, Arbaminch, Ethiopia

  • Department of Medical Laboratory Science, Arbaminch University, Arbaminch, Ethiopia

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