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Stonys R, Vitkus D. Assessing Non-Laboratory Healthcare Professionals' Attitude towards the Importance of Patient Preparation for Laboratory Tests. Healthcare (Basel) 2024; 12:989. [PMID: 38786400 PMCID: PMC11120851 DOI: 10.3390/healthcare12100989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/21/2024] [Accepted: 05/08/2024] [Indexed: 05/25/2024] Open
Abstract
(1) Background: Various guidelines address patient preparation and its importance for venous blood sampling, such as the GP41 guideline issued by the Clinical Laboratory Standards Institute (CLSI) and the blood collection guidelines published by the World Health Organisation. Recommendations provided by national societies or international organisations in the field of radiology, such as The Contrast Media Safety Committee of the European Society of Urogenital Radiology, or in the field of laboratory medicine, such as the Working Group for Preanalytical Phase (WG-PRE) of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and the Latin American Working Group for Preanalytical Phase (WG-PRE-LATAM) of the Latin American Confederation of Clinical Biochemistry (COLABIOCLI), also guide this practice. There is a notable lack of understanding regarding the viewpoints held by non-laboratory healthcare professionals concerning the significance of patient preparation for laboratory testing and the impact of typical factors associated with patient preparation. This study endeavours to bridge this gap by assessing the attitude of non-laboratory healthcare professionals in Lithuania regarding these pivotal aspects. (2) Methods: A self-designed anonymous questionnaire was disseminated among 141 public healthcare institutions in Lithuania. The internal consistency of the questionnaire was evaluated by computing Cronbach's alpha. Descriptive statistics were utilised for the variables, while comparisons of attitude among groups were conducted using Mann-Whitney U (for two groups) or Kruskal-Wallis (for more than two groups) for categorical and discrete indicators. The Kruskal-Wallis post-hoc test was employed for pairwise comparisons. A significance level of p-Value < 0.05 was applied to establish statistical significance. (3) Results: A total of 158 respondents constituted two distinct groups of healthcare professionals: nurses and physicians. Most of the participants either agreed or strongly agreed that patient preparation could introduce bias into laboratory test results. Professionals with less than 20 years of work experience or those who attended training in patient preparation for sampling within a 5-year timeframe exhibited stronger agreement regarding different preanalytical factors in patient preparation and their impact on laboratory test results compared to their counterparts. (4) Conclusions: Non-laboratory healthcare professionals who participated in this survey consider proper patient preparation for laboratory testing to be a significant step towards obtaining accurate test results. They also recognize the commonly acknowledged preanalytical factors as important for ensuring reliable test results. However, attitudes towards the importance of several preanalytical factors vary depending on whether non-laboratory healthcare professionals have more or less than 20 years of work experience, as well as whether they have attended any training on this topic within the last five years or have never attended such training.
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Affiliation(s)
- Ričardas Stonys
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, M.K. Ciurlionio str. 21, LT-03101 Vilnius, Lithuania;
- Centre of Laboratory Medicine, Vilnius University Hospital Santaros Klinikos, Santariskiu str. 2, LT-08406 Vilnius, Lithuania
| | - Dalius Vitkus
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, M.K. Ciurlionio str. 21, LT-03101 Vilnius, Lithuania;
- Centre of Laboratory Medicine, Vilnius University Hospital Santaros Klinikos, Santariskiu str. 2, LT-08406 Vilnius, Lithuania
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2
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Andrade NSV, Curtin SN, Masih A, Fitzgibbon B, Herbert K, Gowen M, Lehane M, Costelloe SJ. Instructions on appropriate fasting prior to phlebotomy; effects on patient awareness, preparation, and biochemical parameters. Diagnosis (Berl) 2023; 10:175-182. [PMID: 36756992 DOI: 10.1515/dx-2022-0131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/27/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVES This study investigated the effect of appropriate pre-phlebotomy instructions on patients' awareness of the need to fast, their fasting status at phlebotomy, and the measurement of specific biochemical analytes and indices. METHODS While booking their phlebotomy appointments, two-hundred outpatients, with a wide range of pre-existing medical conditions, were recruited and randomly assigned to either control or intervention groups. The control group received no instructions while the intervention group was verbally instructed to fast for precisely 12 h prior to their appointment. Serum samples were collected from participants to quantify common biochemical analytes and serum indices, some of which were known to be influenced by fasting status, such as triglyceride and the lipaemic index. At the same appointment, participants completed a survey assessing their perception of, and adherence to, fasting requirements. RESULTS In the intervention group, 99% responded that they had fasted before phlebotomy vs. 16% of controls. Subjects stated they fasted for 12 h in 51% of the intervention group and 7% of the controls. Median concentrations for potassium and total bilirubin were statistically, but not clinically, significantly different. In the study, a single patient in the intervention group was found to have a lipaemic sample. CONCLUSIONS Without instruction, it appears few patients will fast appropriately prior to blood collection. This study suggests that most patients recall and adhere to verbal instructions regarding fasting. Though many in the control group stated they did not fast, triglyceride concentration and lipaemia were not significantly different from the intervention group, and biochemical analyses appear unaffected by fasting status.
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Affiliation(s)
- Nélia S V Andrade
- Department of Clinical Biochemistry, Cork University Hospital, Cork, Republic of Ireland
| | - Sinead N Curtin
- Department of Clinical Biochemistry, Cork University Hospital, Cork, Republic of Ireland
| | - Ashiq Masih
- Phlebotomy Department, Cork University Hospital, Cork, Republic of Ireland
| | - Brid Fitzgibbon
- Phlebotomy Department, Cork University Hospital, Cork, Republic of Ireland
| | - Katie Herbert
- Phlebotomy Department, Cork University Hospital, Cork, Republic of Ireland
| | - Mary Gowen
- Phlebotomy Department, Cork University Hospital, Cork, Republic of Ireland
| | - Margaret Lehane
- Phlebotomy Department, Cork University Hospital, Cork, Republic of Ireland
| | - Seán J Costelloe
- Department of Clinical Biochemistry, Cork University Hospital, Cork, Republic of Ireland
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Bokulić A, Zec I, Goreta S, Nikolac Gabaj N, Kocijančić M, Serdar Hiršl T, Đuras A, Troha M, Stanišić L, Šupe-Domić D, Ćosić SJ, Đurić K, Marijančević D, Siter Kuprešanin M, Lukić I, Pezo A, Leniček Krleža J. Laboratory policies and practices for thyroid function tests in Croatia: survey on behalf of Working Group for Laboratory Endocrinology of the Croatian Society of Medical Biochemistry and Laboratory Medicine. Biochem Med (Zagreb) 2022; 32:030702. [PMID: 35966262 PMCID: PMC9344866 DOI: 10.11613/bm.2022.030702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/11/2022] [Indexed: 11/08/2022] Open
Abstract
Introduction Laboratory plays important part in screening, diagnosis, and management of thyroid disorders. The aim of this study was to estimate current laboratory preanalytical, analytical and postanalytical practices and policies in Croatia. Materials and methods Working Group for Laboratory Endocrinology of the Croatian Society of Medical Biochemistry and Laboratory Medicine designed a questionnaire with 27 questions and statements regarding practices and protocols in measuring thyroid function tests. The survey was sent to 111 medical biochemistry laboratories participating in external quality assurance scheme for thyroid hormones organized by Croatian Centre for Quality Assessment in Laboratory Medicine. Data is presented as absolute numbers and proportions. Results Fifty-three participants returned the questionnaire. Response rate varied depending on question, yielding a total survey response rate of 46-48%. All respondents perform thyroid stimulating hormone (TSH). From all other thyroid tests, most performed is free thyroxine (37/53) and least TSH-stimulating immunoglobulin (1/53). Laboratories are using nine different immunoassay methods. One tenth of laboratories is verifying manufacturer’s declared limit of quantification for TSH and one third is verifying implemented reference intervals for all performed tests. Most of laboratories (91%) adopt the manufacturer’s reference interval for adult population. Reference intervals for TSH are reported with different percentiles (90, 95 or 99 percentiles). Conclusion This survey showed current practices and policies in Croatian laboratories regarding thyroid testing. The results identified some critical spots and will serve as a foundation in creating national guidelines in order to harmonize laboratory procedures in thyroid testing in Croatia.
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Affiliation(s)
- Adriana Bokulić
- Laboratory of Endocrinology, Department of Oncology and Nuclear Medicine, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
- Corresponding author:
| | - Ivana Zec
- Laboratory of Endocrinology, Department of Oncology and Nuclear Medicine, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Sanja Goreta
- Laboratory of Endocrinology, Department of Oncology and Nuclear Medicine, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Nora Nikolac Gabaj
- University Department of Chemistry, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
- Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
| | - Marija Kocijančić
- Central Laboratory, University Hospital Halle, Halle (Saale), Germany
| | - Tihana Serdar Hiršl
- Medical Biochemistry Laboratory, Synlab Hrvatska-Polyclinic for Medical Laboratory Diagnostics, Zagreb, Croatia
| | - Anamarija Đuras
- Department of Medical Biochemistry Laboratory, General Hospital Varaždin, Varaždin, Croatia
| | - Mateja Troha
- Department of Laboratory Diagnostics, General Hospital Dr. Josip Benčević, Slavonski Brod, Croatia
| | - Lada Stanišić
- Department of Medical Laboratory Diagnostics, University Hospital of Split, Split, Croatia
| | - Daniela Šupe-Domić
- Department of Medical Laboratory Diagnostics, University Hospital of Split, Split, Croatia
- Department of Health Studies, University of Split, Split, Croatia
| | - Sanda Jelisavac Ćosić
- Department of Nuclear Medicine and Radiation Protection, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Koraljka Đurić
- Medical Biochemistry Laboratory, Special Hospital AGRAM, Zagreb, Croatia
| | - Domagoj Marijančević
- Laboratory of Endocrinology, Department of Oncology and Nuclear Medicine, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Marija Siter Kuprešanin
- Department of Medical Laboratory Diagnostics, University Hospital Sveti Duh, Zagreb, Croatia
| | - Iva Lukić
- Department for Clinical Laboratory Diagnostics, University Hospital Centre Osijek, Osijek, Croatia
| | - Alenka Pezo
- Medical Biochemistry Laboratory, Primary Health Care Centre Zagreb - East, Zagreb, Croatia
| | - Jasna Leniček Krleža
- Croatian Society of Medical Biochemistry and Laboratory Medicine (CROQALM), Zagreb, Croatia
- Department of Laboratory Diagnostics, Children’s Hospital Zagreb, Zagreb, Croatia
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Bottini PV, Garlipp CR, Lima PRM, Brito IT, Carvalho LMG. Are patients adequately informed about procedures for 24-h urine collection? Clin Chem Lab Med 2020; 58:e32-e35. [PMID: 31352432 DOI: 10.1515/cclm-2019-0368] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 07/11/2019] [Indexed: 11/15/2022]
Affiliation(s)
- Paula V Bottini
- Division of Clinical Pathology, University of Campinas, Campinas, Brazil
| | - Célia R Garlipp
- Department of Clinical Pathology, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Paulo R M Lima
- Division of Clinical Pathology, University of Campinas, Campinas, Brazil
| | - Igor T Brito
- Division of Clinical Pathology, University of Campinas, Campinas, Brazil
| | - Laura M G Carvalho
- Division of Clinical Pathology, University of Campinas, Campinas, Brazil
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López-Garrigós M, Flores E, Bourahel Y, Leiva-Salinas P, Ortega-Lamaignere M, Puerta MJ. [Patient preparation prior to the blood test: Importance in quality of the results]. J Healthc Qual Res 2020; 35:56-58. [PMID: 31974059 DOI: 10.1016/j.jhqr.2019.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 08/14/2019] [Accepted: 08/17/2019] [Indexed: 06/10/2023]
Affiliation(s)
- M López-Garrigós
- Servicio de Análisis Clínicos, Hospital Universitario San Juan de Alicante, San Juan de Alicante, Alicante, España.
| | - E Flores
- Servicio de Análisis Clínicos, Hospital Universitario San Juan de Alicante, San Juan de Alicante, Alicante, España; Departamento de Medicina Clínica, Universidad Miguel Hernández, Elche, Alicante, España
| | - Y Bourahel
- Departamento de Medicina Clínica, Universidad Miguel Hernández, Elche, Alicante, España
| | - P Leiva-Salinas
- Departamento de Medicina Clínica, Universidad Miguel Hernández, Elche, Alicante, España
| | - M Ortega-Lamaignere
- Servicio de Cirugía, Hospital General Universitario de Alicante, Alicante, España
| | - M J Puerta
- Servicio de Análisis Clínicos, Hospital Universitario San Juan de Alicante, San Juan de Alicante, Alicante, España
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Benozzi SF, Unger G, Campion A, Pennacchiotti GL. Fasting conditions: Influence of water intake on clinical chemistry analytes. Biochem Med (Zagreb) 2017; 28:010702. [PMID: 29187795 PMCID: PMC5701773 DOI: 10.11613/bm.2018.010702] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 10/08/2017] [Indexed: 11/01/2022] Open
Abstract
Introduction Currently available recommendations regarding fasting requirements before phlebotomy do not specify any maximum water intake volume permitted during the fasting period. The aim was to study the effects of 300 mL water intake 1 h before phlebotomy on specific analytes. Materials and methods Blood was collected from 20 women (median age (min-max): 24 (22 - 50) years) in basal state (T0) and 1 h after 300 mL water intake (T1). Glucose, total proteins (TP), urea, creatinine, cystatin C, total bilirubin (BT), total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides (Tg), uric acid (UA), high-sensitivity C-reactive protein, gamma-glutamyl transferase (GGT), aspartate-aminotransferase (AST), alanine-aminotransferase and lactate-dehydrogenase (LD) were studied. Results were analyzed using Wilcoxon test. Mean difference (%) was calculated for each analyte and was further compared with reference change value (RCV). Only mean differences (%) higher than RCV were considered clinically significant. Results Significant differences (median T0vs median T1, P) were observed for TP (73 vs 74 g/L, 0.001); urea (4.08 vs 4.16 mmol/L, 0.010); BT (12 vs 13 µmol/L, 0.021); total cholesterol (4.9 vs 4.9 mmol/L, 0.042); Tg (1.05 vs 1.06 mmol/L, 0.002); UA (260 vs 270 µmol/L, 0.006); GGT (12 vs 12 U/L, 0.046); AST (22 vs 24 U/L, 0.001); and LD (364 vs 386 U/L, 0.001). Although the differences observed were statistically significant, they were not indicative of clinically significant changes. Conclusions A water intake of 300 mL 1 h prior to phlebotomy does not interfere with the analytes studied in the present work.
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Affiliation(s)
- Silvia F Benozzi
- Bioquímica Clínica I, Departamento de Biología, Bioquímica y Farmacia, Universidad Nacional del Sur, Bahía Blanca, Argentina
| | - Gisela Unger
- Bioquímica Clínica I, Departamento de Biología, Bioquímica y Farmacia, Universidad Nacional del Sur, Bahía Blanca, Argentina
| | - Amparo Campion
- Bioquímica Clínica I, Departamento de Biología, Bioquímica y Farmacia, Universidad Nacional del Sur, Bahía Blanca, Argentina.,Hospital Municipal de Agudos ''Dr. Leónidas Lucero'', Bahía Blanca, Argentina
| | - Graciela L Pennacchiotti
- Bioquímica Clínica I, Departamento de Biología, Bioquímica y Farmacia, Universidad Nacional del Sur, Bahía Blanca, Argentina.,Hospital Municipal de Agudos ''Dr. Leónidas Lucero'', Bahía Blanca, Argentina
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Lippi G, Cervellin G. Acutely developing, spurious anaemia without actual blood loss. A paradigmatic case report. Biochem Med (Zagreb) 2017; 27:421-425. [PMID: 28694733 PMCID: PMC5493172 DOI: 10.11613/bm.2017.045] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 03/22/2017] [Indexed: 11/10/2022] Open
Abstract
We describe the case of a 55-year old women admitted at night to the emergency department (ED), complaining for acute abdominal pain lasting for nearly 5 hours. A first blood testing, performed immediately after admission, revealed mild anaemia. A second blood sample, drawn two hours after admission, revealed a considerable decrease of haemoglobin, haematocrit, total white blood cell and platelet counts (between 10-15% reduction). Abdominal ultrasonography was normal and the patient had no signs or symptoms of internal or external haemorrhage. Pre-analytical and analytical errors were accurately excluded. No infusion therapy was administered. After thoughtful discussing the sequence of events, it was ascertained that the first set of blood samples was drawn with the patient in seated position, immediately after ED admission (i.e., approximately 1 min passed from standing to seated position before venipuncture), whereas the second set of blood samples was drawn with the patient lying for two hours in supine position. This case report highlights the importance of standardizing patient position before venous blood collection, along with the crucial role played by cooperation and communication between laboratory and clinical wards for identifying and troubleshooting potential causes of spurious results of in vitro diagnostic testing.
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Affiliation(s)
- Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
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Nikolac N, Krleza JL, Simundic AM. Preanalytical external quality assessment of the Croatian Society of Medical Biochemistry and Laboratory Medicine and CROQALM: finding undetected weak spots. Biochem Med (Zagreb) 2017; 27:131-143. [PMID: 28392736 PMCID: PMC5382847 DOI: 10.11613/bm.2017.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 01/14/2017] [Indexed: 11/01/2022] Open
Abstract
INTRODUCTION The aim of this paper is to present results of first two years of preanalytical external quality assessment (EQA) in Croatia. MATERIALS AND METHODS This paper summarizes results from 6 rounds of preanalytical EQA during 2014-2016 in 161-175 Croatian laboratories (number ranged between cycles). EQA was designed as an online survey of the compliance with National recommendations for phlebotomy (NRP). Forty-seven questions in 5 categories are analyzed (materials and equipment, patient identification, patient preparation, sampling and storage). Additionally, preanalytical cases are presented. Overall performance scores (Question score (Qscore) for compliance with NRP and Case score (Cscore) for preanalytical cases) are calculated for each question/case as a proportion of laboratories with satisfactory procedure (x 100). Qscores and Cscores ≥ 70 were classified as acceptable (maximal score = 100). RESULTS In investigation of compliance with NRP, acceptable Qscores were obtained for 34/47 questions. The lowest scores were observed for the availability of sterile disposable tourniquets (Qscore = 15) and safe-sharp needles (Qscore = 34), obtaining patients address as an identifier (Qscore = 21), using glycolysis inhibitor tubes for glucose concentration measurement (Qscore = 21) and verification of manufacturers declarations on temperature and time of storage (Qscore = 31). There was no statistically significant difference in overall Qscore according to different categories of phlebotomy procedures (P = 0.284). The results of preanalytical cases showed acceptable Cscore values for all cases (89-96). CONCLUSION First two years of preanalytical EQA showed good compliance with the NRP and excellent expertise in resolving complex preanalytical issues. Major critical spots are lack of availability of safe-sharp needles, disposable tourniquets and glucose inhibitor tubes.
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Affiliation(s)
- Nora Nikolac
- University Department of Chemistry, Medical School University Hospital Sestre Milosrdnice, Zagreb, Croatia; Working group for preanalytical phase, Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia
| | - Jasna Lenicek Krleza
- Department of laboratory diagnostics, Children's hospital Zagreb, Croatia; CROQALM, Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia
| | - Ana-Maria Simundic
- Working group for preanalytical phase, Croatian Society of Medical Biochemistry and Laboratory Medicine, Zagreb, Croatia; Department of Medical Laboratory Diagnostics, University Hospital "Sveti Duh", Zagreb, Croatia
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Miler M, Nikolac N. Patient safety is not compromised by excluding microscopic examination of negative urine dipstick. Ann Clin Biochem 2017; 55:77-83. [PMID: 28178863 DOI: 10.1177/0004563216687589] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Microscopic examination of samples with negative dipstick results is not necessary. The aims of this study were to: (i) assess the risk of excluding urine sediment examination with negative dipstick results and (ii) calculate time savings by introducing this process. Methods The risk analysis was done for samples with negative urine dipstick and positive sediment findings. Possible missed elements in sediment were defined as 21 errors. Time saving was calculated as average time for preparation and examination sediments. Data were presented as counts and percentages. Results Out of 2997 samples, negative dipstick results were reported for 926 (30.6%) samples, out of which, microscopic examinations were positive for 527 (17.6%) samples. 18/21 errors were detected, with missing <5 squamous epithelial cells (SQEC) and bacteria 1+ as the most frequent ones (22.7% and 22.4%, respectively). Errors with the intermediate risk for patients were missing to report: ≥5 SQEC, ≥5 transitional epithelial cells, ≥10 hyaline casts (11.9%, 0.21%, 0.32%, respectively). Errors associated with high risk were not detected. Estimated total time saving is more than 25 h/month. Conclusions Microscopic examination of urine samples with negative dipstick results can be excluded without risk for patients and can result with considerable time savings.
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Affiliation(s)
- Marijana Miler
- University Department of Chemistry, Medical School University Hospital, Sestre Milosrdnice, Zagreb, Croatia
| | - Nora Nikolac
- University Department of Chemistry, Medical School University Hospital, Sestre Milosrdnice, Zagreb, Croatia
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Cornes MP, Church S, van Dongen-Lases E, Grankvist K, Guimarães JT, Ibarz M, Kovalevskaya S, Kristensen GB, Lippi G, Nybo M, Sprongl L, Sumarac Z, Simundic AM. The role of European Federation of Clinical Chemistry and Laboratory Medicine Working Group for Preanalytical Phase in standardization and harmonization of the preanalytical phase in Europe. Ann Clin Biochem 2016; 53:539-47. [PMID: 27141012 DOI: 10.1177/0004563216643969] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2016] [Indexed: 11/16/2022]
Abstract
Patient safety is a leading challenge in healthcare and from the laboratory perspective it is now well established that preanalytical errors are the major contributor to the overall rate of diagnostic and therapeutic errors. To address this, the European Federation of Clinical Chemistry and Laboratory Medicine Working Group for Preanalytical Phase (EFLM WG-PRE) was established to lead in standardization and harmonization of preanalytical policies and practices at a European level. One of the key activities of the WG-PRE is the organization of the biennial EFLM-BD conference on the preanalytical phase to provide a forum for National Societies (NS) to discuss their issues. Since 2012, a year after the first Preanalytical phase conference, there has been a rapid growth in the number of NS with a working group engaged in preanalytical phase activities and there are now at least 19 countries that have one. As a result of discussions with NS at the third conference held in March 2015 five key areas were identified as requiring harmonisation. These were test ordering, sample transport and storage, patient preparation, sampling procedures and management of unsuitable specimens. The article below summarises the work that has and will be done in these areas. The goal of this initiative is to ensure the EFLM WG-PRE produces work that meets the needs of the European laboratory medicine community. Progress made in the identified areas will be updated at the next preanalytical phase conference and show that we have produced guidance that has enhanced standardisation in the preanalytical phase and improved patient safety throughout Europe.
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Affiliation(s)
- Michael P Cornes
- Departments of Clinical Chemistry, New Cross Hospital, Wolverhampton, West Midlands, UK
| | | | | | - Kjell Grankvist
- The Department of Medical Biosciences, Clinical Chemistry, Umea University, Umea, Sweden
| | - João T Guimarães
- Department of Clinical Pathology, São João Hospital Center, Department of Biochemistry, Faculty of Medicine, and EPI Unit, Institute of Public Health, University of Porto, Porto, Portugal
| | - Mercedes Ibarz
- Laboratori Clínic Hospital Arnau de Vilanova, Lleida, Spain
| | - Svetlana Kovalevskaya
- Clinical Laboratory Diagnostic Department with Course of Molecular Medicine, First Saint Petersburg Pavlov State Medical University, St-Petersburg, Russia
| | | | - Giuseppe Lippi
- Section of Clinical Chemistry, University of Verona, Verona, Italy
| | - Mads Nybo
- Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - Ludek Sprongl
- Central Laboratory, Hospital Sumperk, Sumperk, Czech Republic
| | - Zorica Sumarac
- Center for Medical Biochemistry, Clinical Center of Serbia, Belgrade, Serbia
| | - Ana-Maria Simundic
- Department of Medical Laboratory Diagnostics, Clinical Hospital Sveti Duh, Zagreb, Croatia
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