Carraro Paolo, Plebani Mario
Department of Laboratory Medicine, Azienda Ospedaliera-Università and Azienda ULSS 16, Padova, Italy.
Clin Chem. 2007 Jul;53(7):1338-42. doi: 10.1373/clinchem.2007.088344. Epub 2007 May 24.
In view of increasing attention focused on patient safety and the need to reduce laboratory errors, it is important that clinical laboratories collect statistics on error occurrence rates over the whole testing cycle, including pre-, intra-, and postanalytical phases.
The present study was conducted in 2006 according to the design we previously used in 1996 to monitor the error rates for laboratory testing in 4 different departments (internal medicine, nephrology, surgery, and intensive care). For 3 months, physicians and nurses were asked to pay careful attention to all test results. Any suspected laboratory error was recorded with associated pertinent clinical information. Every day, a laboratory physician visited the 4 departments and a critical appraisal was made of any suspect results.
Among a total of 51 746 analyses, clinicians notified us of 393 questionable findings, 160 of which were confirmed as laboratory errors. The overall frequency of errors, 3092 ppm, was significantly lower (P <0.05) than in 1996 (4700 ppm). Of the 160 confirmed errors, 61.9% were preanalytical errors, 15% were analytical, and 23.1% were postanalytical.
During the last decade the error rates in our stat laboratory have been reduced significantly. As demonstrated by the distribution pattern, the pre- and postanalytical steps still have the highest error prevalences, but changes have occurred in the types and frequencies of errors in these phases of testing.
鉴于对患者安全的关注度不断提高以及减少实验室误差的必要性，临床实验室收集整个检测周期（包括分析前、分析中和分析后阶段）的误差发生率统计数据非常重要。
本研究于2006年按照我们先前在1996年使用的设计进行，以监测4个不同科室（内科、肾病科、外科和重症监护室）的实验室检测误差率。在3个月的时间里，要求医生和护士密切关注所有检测结果。任何疑似实验室误差都要记录相关的临床信息。每天，一名实验室医生走访这4个科室，并对任何可疑结果进行严格评估。
在总共51746次分析中，临床医生向我们通报了393个可疑结果，其中160个被确认为实验室误差。误差的总体发生率为3092 ppm，显著低于1996年（4700 ppm）（P<0.05）。在160个已确认的误差中，61.9%为分析前误差，15%为分析误差，23.1%为分析后误差。
在过去十年中，我们急诊实验室的误差率显著降低。从分布模式可以看出，分析前和分析后步骤的误差发生率仍然最高，但在检测的这些阶段，误差的类型和频率已经发生了变化。
