Effect of training on improvement in the preanalytical errors in venous blood sampling at a tertiary care center

Background Preanalytical phase of laboratory testing is defined as that which includes clinician’s request for examination, patient preparation, sample collection, and transportation of specimen to the laboratory. Any errors occurring during this phase are referred to as preanalytical errors (PAEs). Objective The objective is to study the effect of training on improvement in the PAEs in venous blood sampling at a tertiary care center. Materials and Methods An observational prospective study was carried out in two phases of 6 months each in the outpatient department collection center, Gandhi Hospital, Secunderabad. First, venous blood samples collected were observed for the following errors: (1) incorrect volume of specimen, (2) hemolyzed samples, (3) clotted samples, (4) wrong vacutainer used, and (5) samples without requisition forms. The evaluation for performance based on quality indicators given by the International Federation of Clinical Chemistry Laboratory Medicine working group on Laboratory Errors and Patient Safety was done. Later, training classes were conducted on the correct phlebotomy techniques for the staff, and then venous blood samples were observed again for any errors. Results Of 43,286 samples collected in the first 6 months, 2208 (5.1%) were found to have errors. The most common cause for rejection was hemolysis followed next by samples collected in inappropriate tubes. Following the training session, a total of 41,064 samples were observed in the next phase. Of these, only 4.6% were found to have errors. Conclusion After training the laboratory technicians on the correct techniques of sample collection, there was a significant reduction in the percentage of errors. Therefore, it is important to give continuous training and education to reduce the frequency of errors and improve the quality of lab testing.