It includes specimen collection, handling and processing variables. Clia compliance for preanalytic, analytic, and postanalytic testing phases. See section 6 for more detail about specific analytes. Preanalytical, analytical, and postanalytical phases of. Identification of the types of preanalytical errors in the. The significance of the diff erences between samples was assessed by paired students ttest after checking for normality. Whereas prepreanalytical phase happens outside the laboratory and composes of the selection of appropriate tests based on the clinical question, ordering, collecting and handling, transportation. Preanalytical errors damage an institutions reputation, diminish confidence in healthcare services, and contribute to a significant increase in the total operating costs, both for the hospital and laboratory. View and download powerpoint presentations on preanalytical ppt. Sample collection part 1 errors during collection, processing and transport of biological specimens are common ref.
Preanalytical quality in clinical chemistry laboratory. Preanalytical errors in medical laboratories ashishkumar soni qms manager west randox laboratories india pvt. Preanalytical errors in clinical chemistry laboratory of. Reusable glass syringes with steel hypodermic needles and a hard rubber hub were the first devices used to collect blood 1. Ppt preanalytical laboratory errors powerpoint presentation free to download id. The terms of reference of this wg are many and ambitious, encompassing i the promotion of importance of quality in the preanalytical phase. Factors affecting the usefulness of laboratory data may arise in any of the preanalytical, analytical or postanalytical phase of the testing cycle. Analytical and postanalytical error in clinical chemistry laboratory hanisha erica p.
Various types of errors that we, as clinical biochemists, encounter in the laboratory are classified as preanalytical, analytical, and postanalytical, depending upon the time of presentation. A companion reference to effects of drugs on clinical laboratory tests, effects of disease on clinical laboratory tests, and effects of herbs and natural products on clinical laboratory tests, this new edition completes the background information of what you need to know to interpret clinical laboratory test values. Preanalytical variation includes all the steps that occur from test ordering until right before sample analysis. This involves patient identification, physical sample collection, sample transportation to the testing site and sample preparation. Preanalytical issues in the haemostasis laboratory. Preanalytical variables and factors that interfere with. Many new entries are included, and entries from prior editions. Find powerpoint presentations and slides using the power of, find free presentations research about preanalytical ppt. Physicians and clinical staff can misinterpret test names and order the wrong test or methodology. Preanalytical variables and factors that interfere with the biochemical parameters. Chemistry analyzers the different methods measure on different specimen types, such as the plasma phase of whole blood, whole blood, plasma or hemolysate. Preanalytical variables and factors that interfere with the.
Post analytical errors in clinical laboratory bcma. Analytical errors test system not calibrated results reported when control results out of range improper measurements of specimens andor reagents. In this lesson, sources of errors for the preanalytic and postanalytic phases of the total testing process are discussed, along with possible solutions. Preanalytical errors and their impact on tests in clinical. A retrospective analysis of the results obtained from the clinical chemistry laboratory for errors in the preanalytical phase has been carried out to summarize data regarding the frequency of the main factors affecting the preanalytical quality of results. First, the test must sample the matrix in which the target analyte is present. Preanalytical phase an overview sciencedirect topics. Early modifications included a refined needle, replacement of the rubber hub with glass, and the luerlok syringe, which modified the needle tip for a more secure attachment to the syringe and ensuring a more reliable and safer drug delivery 1. Effects of preanalytical variables on the quality of laboratory testing.
Paying close attention to the preanalytical variables associated with blood collection is critical in ensuring accurate test results in all areas of the clinical laboratory. We monitored the frequency and type of preanalytical errors by screening all the inpatient venous blood samples received from the wards collected by the nursesinterns before the analytical phase was undertaken. Preanalytical variablespreanalytical variables tapeshwar yadav lecturer bmlt, dnhe, m. Ensuring quality has become a daily requirement in laboratories. Prevalence of preanalytical errors in clinical chemistry. However, recent studies have shown that up to 70% of analytical errors reflect the preanalytical phase. There are preanalytical, analytical and post analytical factors that contribute to accurate test results in clinical laboratories. Laboratory quality control ppt download laboratory errors in stat testing. Effects of preanalytical variables on clinical laboratory tests young, donald s. Identification of specific preanalytical quality control markers. Analytical techniques for clinical chemistry wiley. Useful tips to avoid preanalytical errors in blood gas. A free powerpoint ppt presentation displayed as a flash slide show on.
Clia compliance for preanalytic, analytic, and post. It can be difficult to distinguish between preanalytical errors and analytical variations that come from different measuring techniques 32,33 especially if the different methods are. Effects of preanalytical variables on clinical laboratory. The preanalytical phase of a diagnostic test refers to all of the steps required to deliver the analyte from the sampled environment or patient to the analytical assay. The preanalytic testing phase occurs first in the laboratory process. This phase may include specimen handling issues that occur even prior to the time the specimen is received in the laboratory. Analytical techniques for clinical chemistry opens with an overview of the legal and regulatory framework governing clinical lab analysis. Pre analy tical phase in clinical chemistry laboratory sohini sengupta neogi, 1 mohit mehndiratt a, 2 stuti gupta, 2 dinesh puri 2 department of 1 bioc hemistry, sir gangaram hospital, delhi and. Basic concepts of clinical chemistry generally speaking, clinical chemistry is nothing else but qualitative andor quantitative chemical analysis of highly complex samples body fluids, cells, tissues etc. Diagnostic technology for minimizing preanalytical errors.
Chemistry and laboratory medicine eflm working group. The level of statistical significance was set at p ppt video online download. Biological factors, such as fasting, may require the patient to prepare before specimen collection or a sample may need to be collected at an appropriate time for therapeutic. Defined as errors which occur when non analytical factors change the conc. The tests in a clinical chemistry laboratory measure concentrations of biologically important ions salts and minerals, small organic molecules and large macromolecules primarily proteins. Interferences from blood collection tube components on. While the likelihood of variation in any of the three phases is not negligible, the vast majority of laboratory variation emerges from the many factors affecting laboratory specimens prior to testing. The preanalytical phase comprises all processes from the time a. The objective of the clinical laboratory improvement amendments clia program is to ensure quality medical laboratory testing, which leads to better patient outcomes. Prior to collecting specimens for chemistry, certain patient variables need to be considered. Important errors can occur during the preanalytic phase with specimen handling and identification. Preanalytical factors are the main source of variation in clinical chemistry testing and among the major determinants of preanalytical variability, sample hemolysis can exert a.
D, in accurate results in the clinical laboratory second edition, 2019. Effects of preanalytical variables on clinical laboratory tests. Analytical and post analytical errors in laboratory 1. Postanalytical phase an overview sciencedirect topics. All the samples received in the hematology laboratory of dayanand medical college and hospital, ludhiana, india over a period of one year july 20july 2014 were included in the study and preanalytical variables like clotted samples, quantity not sufficient, wrong sample, without label, wrong label were studied. The preanalytical phase is an important component of laboratory medicine. For certain chemistry analytes, such as glucose and cholesterol, patients need to be fasting absence of food and liquids for at least 12 hours prior to venipuncture. Preanalytical and postanalytical qc often these papers play a zerosum game, emphasizing pre and postanalytical quality while diminishing the importance of analytical quality. Expertly curated help for tietz fundamentals of clinical chemistry. Analytical and post analytical errors in laboratory. Most errors affecting laboratory test results occur in the preanalytical phase, primarily because of the difficulty in achieving standardized procedures for sample collection. Estimation of preanalytical uncertainty in clinical chemistry.
As the clinical emphasis of immunohistochemistry shifts from single marker to multiplex analysis, a thorough understanding of the roles that preanalytical and analytical variables play in the accuracy of results will be crucial for the accurate delineation of cellular interactions between tumor and immune cells. Understanding preanalytical variables and their effects on. In haemostasis, even more than in other disciplines of biology, quality is determined by a preanalytical step that encompasses all procedures, starting with the formulation of the medical question, and includes patient preparation, sample collection, handling, transportation, processing, and storage until. Next, it details the latest progress in instrumentation and applications in such fields as biomonitoring, diagnostics, food quality, biomarkers, pharmaceuticals, and forensics. Department of clinical chemistry, katip celebi university, ataturk training and research hospital, izmir, turkey. Plus easytounderstand solutions written by experts for thousands of other textbooks. A model for an uncertainty budget for preanalytical variables in clinical chemistry analyses. Ppt pre analytical variables in clinical chemistry powerpoint. Powerpoint presentation download only for analytical chemistry and quantitative analysis download lecture powerpoints ch0105 applicationzip 9.
Blood is collected by threading the sleevecovered end of the needle np into the holder, then. Preanalytical errors account for 32%75% of laboratory errors 1. Paper ii estimation of the minimal preanalytical uncertainty for 15 clinical chemistry analytes. Powerpoint presentation download only for analytical. Paying close attention to the preanalytical variables associated with blood collection is. Pdf preanalytical phase in clinical chemistry laboratory. To detect the percent of preanalytical errors in clinical biochemistry laboratory. Preanalytical variation in clinical laboratory testing. Clinical chemistry is the branch of laboratory medicine that focuses primarily on molecules. Preanalytical errors in clinical chemistry laboratory of a tertiary care hospital. An evaluation of the errors occurring in pathology and. Background laboratory testing is roughly divided into three phases. Brain to brain patient preparation test ordering specimen acquisition. Store become a certified poct professional if you are a healthcare professional working in pointofcare testing, certification through the aacc board of certification will document that you have proven expertise in this area and are among the top in your field.
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