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 ...
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... 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.
...health of a patient and a follow up check at the GP’s may be required.
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
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).
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
Milani, Oleck and Lavie reported that Medical errors are the eighth leading cause of death in the hospitals. About 44,000 to 98,000 people die each year from adverse effects from medication errors, 1 million annually die in
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
One possible source of experimental error could be not having a solid measurement of magnesium hydroxide nor citric acid. This is because we were told to measure out between 5.6g-5.8g for magnesium hydroxide and 14g-21g for citric acid. If accuracy measures how closely a measured value is to the accepted value and or true value, then accuracy may not have been an aspect that was achieved in this lab. Therefore, not having a solid precise measurement and accurate measurement was another source of experimental error.
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...
Blood stains are one type of evidence that can be found at a crime scene. Blood that is still in the liquid form should be picked up on a gauze pad. Once the blood is dried thoroughly it should be refrigerated and sent to the Laboratory (Andrus et al., n.d., para. 1). If the blood stain is found dried on clothing, the officer should wrap the piece of clothing in clean paper and place it in a sealed and labeled container. An object with dried blood stains needs to be sent to the Laboratory if it is small enough. If the object is too large to send, then using a clean knife the stain needs to be scraped onto a clean piece of paper, which then can be folded and placed in an envelope (Andrus et al., n.d., para. 2). When collecting autopsy blood samples, the officer should request that the pathologist obtain the sample directly from the heart and place it in a yellow or purple stoppered vacutainer. If the victim is still alive but in serious need of a blood transfusion, then the pre-transfusion blood sample needs to be obtained promptly before the hospital discards it (Andrus et al., n.d., para. 4). It is important for the Laboratory to receive all blood samples within 48 ho...
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...
Safety in school labs Safety remains one of the key elements in modern school labs; it is necessary for the staff to ensure the safety of all the lab users. All chemicals and equipment in the laboratory have the potential to harm if adequate safety measures are not taken into account. For lab use, you have to ensure that you follow the basic safety guidelines for the lab sessions. Always be aware of all the general safety precautions and familiarize yourself with the appropriate protective measures that can keep you safe (NIOSH, 2006). It is important to consider that serious damage could occur if the basic safety rules and regulations for lab practice are not followed.
Forensic toxicologists employ a large number of analytical techniques to determine the drugs or poisons relevant to an investigation; the capacity of a laboratory to conduct routine toxicological analysis varies depending upon equipment, technical capability and analyst experience. When needed, there are specialty toxicology labs that can test for almost any potential toxin or metabolite in almost every kind of post-mortem sample. A laboratory should be accredited to perform the analytical work and must be subject to regular inspections. This will ensure that laboratories can reproduce accurate and reliable results for investigations. All laboratory tests conform to standard operating procedures, results are confirmed to meet standards, and reported results are peer reviewed by a second toxicologist before being released. Even so, we still use methods that Gettler used in his
Correction (defects): Adverse drug reactions. Readmission because of inappropriate discharge. Repeating tests because of incorrect information. Waiting Waiting for doctors to discharge patients. Waiting for the test results.