Recommendations for detection and management of unsuitable samples in clinical laboratories
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Giuseppe Lippi
Abstract
A large body of evidence attests that quality programs developed around the analytical phase of the total testing process would only produce limited improvements, since the large majority of errors encountered in clinical laboratories still prevails within extra-analytical areas of testing, especially in manually intensive preanalytical processes. Most preanalytical errors result from system flaws and insufficient audit of the operators involved in specimen collection and handling responsibilities, leading to an unacceptable number of unsuitable specimens due to misidentification, in vitro hemolysis, clotting, inappropriate volume, wrong container or contamination from infusive routes. Detection and management of unsuitable samples are necessary to overcome this variability. The present document, issued by the Italian Inter-society SIBioC-SIMeL-CISMEL (Society of Clinical Biochemistry and Clinical Molecular Biology-Italian Society of Laboratory Medicine-Italian Committee for Standardization of Hematological and Laboratory Methods) Study Group on Extra-analytical Variability, reviews the major causes of unsuitable specimens in clinical laboratories, providing consensus recommendations for detection and management.
Clin Chem Lab Med 2007;45:728–36.
©2007 by Walter de Gruyter Berlin New York
Articles in the same Issue
- Foreword
- Errors in laboratory medicine and patient safety: the road ahead
- How can we make laboratory testing safer?
- “Pre-pre” and “post-post” analytical error: high-incidence patient safety hazards involving the clinical laboratory
- Risk management in the preanalytical phase of laboratory testing
- Recommendations for detection and management of unsuitable samples in clinical laboratories
- Effects of analytic variations in creatinine measurements on the classification of renal disease using estimated glomerular filtration rate (eGFR)
- Process and risk analysis to reduce errors in clinical laboratories
- Reduction of multi-dimensional laboratory data to a two-dimensional plot: a novel technique for the identification of laboratory error
- Does external evaluation of laboratories improve patient safety?
- Risk management in laboratory medicine: quality assurance programs and professional competence
- Point-of-care testing, medical error, and patient safety: a 2007 assessment
- Blood gas and patient safety: considerations based on experience developed in accordance with the Risk Management perspective
- The role of in vitro diagnostic companies in reducing laboratory error
- Application of the Six Sigma concept in clinical laboratories: a review
- One hundred years of laboratory testing and patient safety
Articles in the same Issue
- Foreword
- Errors in laboratory medicine and patient safety: the road ahead
- How can we make laboratory testing safer?
- “Pre-pre” and “post-post” analytical error: high-incidence patient safety hazards involving the clinical laboratory
- Risk management in the preanalytical phase of laboratory testing
- Recommendations for detection and management of unsuitable samples in clinical laboratories
- Effects of analytic variations in creatinine measurements on the classification of renal disease using estimated glomerular filtration rate (eGFR)
- Process and risk analysis to reduce errors in clinical laboratories
- Reduction of multi-dimensional laboratory data to a two-dimensional plot: a novel technique for the identification of laboratory error
- Does external evaluation of laboratories improve patient safety?
- Risk management in laboratory medicine: quality assurance programs and professional competence
- Point-of-care testing, medical error, and patient safety: a 2007 assessment
- Blood gas and patient safety: considerations based on experience developed in accordance with the Risk Management perspective
- The role of in vitro diagnostic companies in reducing laboratory error
- Application of the Six Sigma concept in clinical laboratories: a review
- One hundred years of laboratory testing and patient safety
