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Review
. 2024 Mar 30;16(3):e57243.
doi: 10.7759/cureus.57243. eCollection 2024 Mar.

Preanalytical Errors in Clinical Laboratory Testing at a Glance: Source and Control Measures

Nani Nordin  1 , Siti Nadirah Ab Rahim  1 , Wan Farhana Azwanee Wan Omar  1 , Sarah Zulkarnain  1 , Susmita Sinha  2 , Santosh Kumar  3 , Mainul Haque  4   5
Affiliations
Review

Preanalytical Errors in Clinical Laboratory Testing at a Glance: Source and Control Measures

Nani Nordin et al. Cureus. .

Abstract

The accuracy of diagnostic results in clinical laboratory testing is paramount for informed healthcare decisions and effective patient care. While the focus has traditionally been on the analytical phase, attention has shifted towards optimizing the preanalytical phase due to its significant contribution to total laboratory errors. This review highlights preanalytical errors, their sources, and control measures to improve the quality of laboratory testing. Blood sample quality is a critical concern, with factors such as hemolysis, lipemia, and icterus leading to erroneous results. Sources of preanalytical errors encompass inappropriate test requests, patient preparation lapses, and errors during sample collection, handling, and transportation. Mitigating these errors includes harmonization efforts, education and training programs, automated methods for sample quality assessment, and quality monitoring. Collaboration between laboratory personnel and healthcare professionals is crucial for implementing and sustaining these measures to enhance the accuracy and reliability of diagnostic results, ultimately improving patient care.

Keywords: biological variation; blood sample quality; hemolysis; laboratory error; laboratory process; laboratory quality; laboratory sample rejection; phelebotomy; pre-analytical variables; results inaccuracy.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Flow chart illustration of steps for article selections using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guideline.
Notes: Prisma Guidelines [3]. POCT=Point-of-Care Testing Image Credit: Nani Nordin
Figure 2
Figure 2. Schematic diagram showing the total testing process.
Notes: This figure was drawn using the premium version of BioRender [9] (license number WG26KTF43S). Image Credit: Susmita Sinha
Figure 3
Figure 3. Schematic diagram showing the measures to improve preanalytical error.
Notes: This figure was been drawn with the premium version of BioRender, with the license number LG26KR5WFE. *Harmonization [10]; *Education and training [30,31]; *Hemolytic, icteric, lipemic [4,5,32]; *Quality monitoring [33-35]; *Automation [34,36,37] Image Credit: Susmita Sinha
See this image and copyright information in PMC

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