The literature review was done to gather the information about the most common source of error in the medical laboratory. The majority of errors come from the pre-analytical phase that is considered the basis for all laboratory works. Pre-pre-analytic and true pre-analytic are two areas of the pre-analytical phase (Plebani, 2012). Test selection, patient identification, sample collection, preparation and handling are part of the pre-pre-analytical process, while storing, pipetting and centrifugation sample are actual pre-analytical processes (Hawkins, 2012; Plebani, 2012). Missing any steps in the previous processes will cause errors related to the pre-analytical phase. In addition, pre-analytical errors can result in lack of trust from the patient and medical staff, economic consequences to the patient as well as the medical laboratory department, and unfavourable implication on the medical laboratory department.
As noted in a review of the retrieved articles, the pre-analytical phase is the main source of errors in the laboratory department (Plebani, 2012). Missing patient’s identification, missing samples, and using inappropriate tubes or containers are the most common pre-analytical errors occurring outside the laboratory domain (Plebani, 2012). Missing patient identification includes unlabeled samples and incorrect name and file number (Layfield et al., 2010). Missing samples indicate that the specimen was drawn from the patient, but the laboratory did not receive the sample.
Further, transporting the sample under improper environmental conditions or delays in the sample transportation is considered an error in the pre-pre-analytical phase (Felder, 2011). For example, arterial blood gases samples must be sent in the syringe ...
... middle of paper ...
... Pathology, 134, 466-470.
Plebani, M. & Piva, E. (2010). Medical Errors: Pre-Analytical Issue in Patient Safety. Journal of Medical Biochemistry, 29 (4), 310-314.
Plebani, M. (2012). Quality Indicators to Detect Pre-Analytical Errors in Laboratory Testing. The Clinical Biochemist Reviews, 33 (3), 85-88.
Rin, G. (2010). Pre-Analytical Workstations as a Tool for Reducing Laboratory Errors. Journal of Medical Biochemistry, 29 (4), 315-324.
Sharma, P. (2009). Preanalytical Variables and Laboratory Performance. Indian Journal of Clinical Biochemistry, 24 (2), 109-110.
Wallin, O., Soderberg, J., Van Guelpen, B., Stenlund, H., Grankvist, K. & Brulin, C. (2010). Blood Sample Collection and Patient Identification Demand Improvement: A Questionnaire Study of Preanalytical Practices in Hospital Wards and Laboratories. Scandinavian Journal of Caring Sciences, 24 (3), 581-591.
Faries, D. E., Houston, J. P., Sulcs, E. N., & Swindle, R. W. (2012). A cross-validation of the provisional diagnostic instrument (PDI-4). BioMed Central, 13(1), 104. doi:10.1186/1471-2296-13-104
The article quotes this as the “worst type of preanalytical error”. The reason behind this is the result of this error means that a patient is treated for a disease or illness that they are not suffering from. This could be by medication or treatments even as extreme as chemotherapy. Problems that then grow from this is the effects of the treatment can be life threatening as they are managing a condition that isn’t there. An example of this is if a patient is incorrectly prescribed warfarin, an anticoagulant to treat blood clotting but has no issues with blood clotting the blood will thin and increase blood pressure leading to serious health defects.
First, this text will discuss some background on Labcorp to form a better understanding of the business, and the practices used. Labcorp is one of the largest clinical Laboratories in the world, which includes many wholly owned subsidiaries. The Laboratory Corporation of America (2013) website LabCorp has over 220,000 clients and process over 400,000 samples per day. LabCorp uses an innovative clinical laboratory processing, referral, and specimen testing information systems to create fluent, and easy to use specimen processing and testing. This process has developed through time, and LabCorp has grown into a robust multi- laboratory testing facilities through the buyout, and absorption of numerous specialty laboratories. As the buyout of subsidiaries has been a large part of the growth of this business, information technology had to grow along side, as the connection between all sites became critical for survival, to keep the stance of a premier multifunctional Laboratory tycoon (Laboratory Corporation of America, 2013).
Hospital medical errors can involve medicines (e.g., wrong drug, wrong dose, bad combination), an inaccurate or incomplete diagnosis, equipment malfunction, surgical mistakes, or laboratory errors. High medical error rates with serious consequences occurs in intensive care units, operating rooms, and emergency departments; but, serious errors that harmed patients may have prevented or minimized. Understand the nature of the error
Gany, F., Kapelusznik, L., Prakash, K., Gonzalez, J., Orta, L. Y., Chi-Hong, T., & Changrani, J. (2007). The impact of medical interpretation method on time and errors. JGIM: Journal of General Internal Medicine, 22,319-323.
The most common kind of medication error is administering the wrong medication or giving wrong doses. A medication error is any error that happens to patients whether they suffer any harmful results or not. Inappropriate nurses-to-patients ratio should be taken into consideration because it can cause medication errors. A new study shows that every year about 210,000-400,000 people who were admitted to the hospital die due to medication error; it also shows that is is “the third leading cause of death behind heart disease and cancer”(MacDonald). For instance, an interview was done with Nurse Carol, a retired nurse; she said that she made a medication error while administering medication to one of her patients. She said that she was rushing and accidentally gave Cozaar to one of her patients instead of Colace. Cozaar is often used for high blood pressure and Colace is for constipation. She said her patient’s pressure dropped very low after taking the medication; she realized then that she gave the patient the wrong medication. Nurse Carol also said that if she did no...
The study involved 1,183 participants. The five phases of administering medication were used to further break it down. According to Truitt et al. (2016) the error rate decreased from 0.26% to 0.20%, it was concluded that this was significant enough of a decrease to conclude that the implementation of the systems made a difference. According to Truitt et al. (2016) the number of transcription errors decreased from 134 to 66, making this a significant decrease.
... Berger, eds. 2008. Laboratory Tests and Diagnostic Procedures. 5th ed. St. Louis, Mo.: Saunders Elsevier.
Safety standards for all laboratories should be designed to eliminate risks due the use of potentially dangerous materials. All laboratories contain some form of potential hazards, and the actions and attitudes of those working within the laboratory are who sets precedence of their safety and others surrounding them. Their actions can also effect not only the laboratory but the community that surrounds the location. The manual identifies the biological agents that are used within the laboratory, and points out the exposure mechanisms of these biological agents. It includes the methods of evaluation and control of the biological agents, and covers the methods of sampling biological agents.
Handbook of Laboratory and Diagnostic Tests with Nursing Implications (3rd edition). Philadelphia: F.A. Davis Company.
Monitoring the TAT is one of the most important part of laboratory services. It is considered as the key performer indicator and many clinicians used it to judge the quality of a laboratory. In many critical care laboratories unsatisfactory TAT is a major source of complaints and it directly delays the patient treatment process. To improve the TAT in critical care laboratories, implementing the appropriate corrective measures are always important to maintain the quality assurance and provide the quality patient care.
Most of the laboratory tests ordered from critically ill patient and acute areas such as operating room (OR), emergency department (ED), and Intensive Care Unit (ICU) are performed in the core or stat laboratory. This process is a time consuming
The first test showed a decrease in blood pH and a major increase in the partial pressure of oxygen. The patient was placed on a ventilator during surgery on the date of admission, which could be the reason as to why his partial pressure of oxygen was increased. The patient’s blood pH was low in the first test. While it was barely in the normal range, the patient’s bicarb was close to being low as well. The patient was injured which resulted in fluid shifts that could have affected the amount of bicarbonate in the patient’s blood, resulting in a decrease in the blood’s pH. This means the patient was at risk for metabolic acidosis. The next day the patient’s blood pH had increased to a normal level and the bicarbonate level had also increased. The patent’s partial pressure of oxygen had also decreased, due to a decrease in the fraction of inspired oxygen, possibly from changes to the setting of the
Fischbach, Frances, A Manual of Laboratory & Diagnostic Tests, 4th ed., J. B. Lippincott Company, Philadelphia
Most medical errors come from human errors. Before defining medical error, we should have a good understanding of human error. As a human in our everyday life we are prone to make mistakes such as using ointment...