A Prospective Study on Errors in Pre-Analytical Phase in Central Laboratory: Biochemistry Unit

Background: Pre-analytical errors are a significant source of inaccuracies in clinical biochemistry laboratories, contributing to approximately 60-70% of total laboratory errors. These errors arise during the pre-examination phase, which spans from test ordering to sample analysis. Given the potential impact on diagnostic outcomes, understanding and mitigating these errors is critical to improving laboratory quality.  Objectives: The study aims to enumerate and analyze the frequency of pre-analytical errors in a Clinical Biochemistry laboratory, with a particular focus on assessing the effect of hemolysis on blood glucose levels.  Materials and Methods: Data were collected across various hospital departments, and the occurrence of pre-analytical errors was assessed. The analysis focused on the impact of hemolysis on test results, particularly blood glucose measurements.  Results: The findings reveal significant variation in the frequency of pre-analytical errors across different clinical departments. The Inpatient Department accounted for the highest proportion of errors (50.36%), followed by the Critical Care Medicine department at 43.13%. In contrast, lower rates of errors were observed in the Emergency Department (3.61%) and Outpatient Department (2.89%). Hemolysis was identified as the most prevalent error type, followed by issues such as inadequate sample volume, improper tube selection, labeling errors, and clot formation in serum samples. These findings underscore that pre-analytical errors are particularly common in inpatient and critical care settings, suggesting the need for targeted interventions in these areas.  Conclusion: The study highlights the significant role of pre-analytical factors in shaping laboratory test outcomes. Hemolysis, inadequate sample volume, and other procedural errors were found to be the most frequent contributors to inaccurate results. The research emphasizes the importance of adhering to standardized protocols and implementing quality control measures to reduce errors, enhance the accuracy of laboratory testing, and ultimately improve patient care.