BİR EĞİTİM ARAŞTIRMA HASTANESİ BİYOKİMYA LABORATUVARINDA NUMUNE RED ORANLARININ ANALİZİ

Year 2022, Volume: 10 Issue: 1, 326 - 334, 10.03.2022

Mukadder Erdem , Adem Keskin , Recai Aci

https://doi.org/10.33715/inonusaglik.1016798

Cited By: 1

Abstract

Çalışmamız, biyokimya laboratuvarında çeşitli nedenlerle saptanan numune reddini numune türlerine göre değerlendirmeyi amaçlamıştır. Bu çalışmada, bir eğitim ve araştırma hastanesinin biyokimya laboratuvarında bir yıllık süre içinde saptanan numune reddi nedenleri kategorize edildi. Bu red nedenleri arasında pıhtılı numune, hemolizli numune, yetersiz numune, fazla numune, hatalı alınmış numune, hatalı işlem, hatalı kap/tüp ve hatalı istem nedenleri bulunmaktadır. Bu red nedenleri sedimantasyon, hormon, koagülasyon, Hb A1c, biyokimya, kan gazı, idrar, hemogram numune türlerine göre analiz edildi. 1307013 numuneden 3483'ü (%0.27) reddedilmiştir. Numune red nedenleri; sedimantasyon %0.45, hormon %0.05, koagülasyon %0.54, Hb A1c %0.77, biyokimya %0.30, kan gazı %0.52, idrar %0.21 ve hemogram %0.20 olarak belirlendi. Red nedenleri arasında ilk üç sırada pıhtılı numune, yetersiz numune ve hemolizli numune yer aldı. Personelin sürekli eğitiminin yapılması, tüm personelin işbirliği içinde olması, iş yükünün üstesinden gelebilecek personel temini hayati önem taşımaktadır.

Keywords

Hemolizli numune, Numune reddi, Pıhtılı numune, Preanalitik hata, Yetersiz numune

Analysis of Sample Rejection Rates in a Training and Research Hospital Biochemistry Laboratory

Abstract

Our study aimed to evaluate sample rejection due to various reasons in the biochemistry laboratory according to sample types. In this study, the reasons for sample rejection detected within a one-year period in the biochemistry laboratory of a training and research hospital were categorized. Reasons for this rejection include clotted sample, hemolyzed sample, insufficient sample, excess sample, incorrectly taken sample, incorrect operation, incorrect container/tube and incorrect order reasons. These reasons for rejection were analyzed according to sedimentation, hormone, coagulation, Hb A1c, biochemistry, blood gas, urine, hemogram sample types. 3483 (0.27%) out of 1307013 samples were rejected. Reasons for rejection were determined to be; 0.45% sedimentation, 0.05% hormone, 0.54% coagulation, 0.77% Hb A1c, 0.30% biochemistry, 0.52% blood gas, 0.21% urine and 0.20% hemogram. Among the reasons for rejection, clotted sample, insufficient sample and hemolyzed sample were in the first three ranks. Continuous training of personnel, cooperation of all personnel, and recruitment of personnel who can overcome the workload are of vital importance.

Keywords

Clotted sample, Hemolyzed sample, Insufficient sample, Preanalytical error, Sample rejection

References

• Alsina, M. J., Alvarez, V., Barba, N., Bullich, S. (2008). Preanalytical quality control program an overview of results (2001-2005 summary). Clinical Chemistry and Laboratory Medicine, 46, 849-854.
• Atay, A., Demir, L., Cuhadar, S., Saglam, G. (2014). Clinical biochemistry laboratory rejection rates due to various types of preanalytical errors. Biochemia Medica, 24 (3), 376-382.
• Cao, L., Chen, M., Phipps, R. A., Del Guidice, R. E. (2016). Causes and impact of specimen rejection in a clinical chemistry laboratory. Clinica Chimica Acta, 458, 154-158.
• Carraro, P., Zago, T., Plebani, M. (2012). Exploring the initial steps of the testing process: frequency and nature of pre-preanalytic errors. Clinical Chemistry, 58, 638-642.
• Chiku, C., Zolfo, M., Senkoro, M., Mabhala, M. (2019). Common causes of EID sample rejection in Zimbabwe and how to mitigate them. PLoS ONE., 14 (8), e0210136.
• Coskun, A. (2007). Six Sigma and laboratory consultation. Clinical Chemistry and Laboratory Medicine, 45 (1), 121-123.
• Dağlıoğlu, G., Görüroğlu Öztürk, Ö., İnal, T. (2019). Klinik laboratuvarlarda kalite yönetimi: altı sigma protokolünün uygulanması. Cukurova Medical Journal, 44, 272-280.
• Hammerling, J. A. (2012). A review of medicalerrors in laboratory diagnostics and where we are today. Laboratory Medicine, 43, 41–44.
• Hawkins, R. C. (2007). Laboratory turn around time. The Clinical Biochemist Reviews, 28, 179-194.
• Kirchner, M. J., Funes, V. A., Adzet, C. B., Clar, M. V. (2007). Quality indicators and specifications for keyprocesses in clinical laboratories: a preliminary experience. Clinical Chemistry and Laboratory Medicine, 45, 672-677.
• Lippi, G., Bassi, A., Brocco, G., Montagnana, M. (2006). Preanalytic error tracking in a laboratory medicine department: results of a 1-year experience. Clinical Chemistry, 52, 1442-1443.
• Lundberg, G. D. (1981). Acting on significant laboratory results. JAMA, 245, 1762-1763.
• Özcan, O., Güreser S. (2012). Analiz öncesi (preanalitik) hata kaynakları ve eğitimin hata önlemede ki rolü. Dicle Tıp Dergisi, 39 (4), 524-530.
• Plebani, M., Ceriotti, F., Messeri, G., Ottomano, C. (2006). Laboratory network of excellence: enhancing patient safety and service effectiveness. Clinical Chemistry and Laboratory Medicine, 44, 150-160.
• Plebani, M. (2010). The detection and prevention of errors in laboratory medicine. Annual Clinical Biochemistry, 47, 101-110.
• Plebani, M. (2012). Quality indicators to detect pre–analytical errors in laboratory testing. The Clinical Biochemist Reviews, 33, 85-88.
• Plebani, M., Astion, M. L., Barth, J. H., Chen, W., Cesar, A. O. G. (2014a). Harmonization of quality indicators in laboratory medicine. A preliminary consensus. Clinical Chemistry and Laboratory Medicine, 52 (7), 951-958.
• Plebani, M., Sciacovelli, L., Aita, A., Padoan, A. (2014b). Quality indicators to detect pre–analytical errors in laboratory testing. Clinica Chimica Acta, 432, 44-48.
• Plebani, M., Sciacovelli, L., Aita, A., Pelloso, M. (2015). Performance criteria and quality indicators for the pre-analytical phase. Clinical Chemistry and Laboratory Medicine, 53, 943-948.
• Plebani, M., Sciacovelli, L., Aita, A. (2017). Quality Indicators for the Total Testing Process. Clinical Laboratory Medicine, 37, 187-205.
• Ricos, C., Garcia-Victoria, M., De la Fuente, B. (2004). Quality indicators and specifications for the extra-analytical phases in clinical laboratory management. Clinical Chemistry and Laboratory Medicine, 42, 578-582.
• Simundic, A. M., Bairdb, G., Cadamuroc, J., Costelloed, S. J. (2019). Managing hemolyzed samples in clinical laboratories. Critical Reviews in Clinical Laboratory Sciences, 57 (1), 1-21.
• Taga, Y., Aslan, D., Güner, G., Kutay, Z. F. (2000). Tıbbi Laboratuvarlarda Standardizasyon ve Kalite Yönetimi. Ankara: TBD Yayınları.