Analytical&Postanalytical

Lab errors
Dr.Shymaa Osama Khalil
Analytical phase
Actual performance of the test.

Analytic activities
• Specific reagents .
• Test kits .
• Proper patient information.
• Proper interpretation- include disclaimers.
Factors influencing analytic activities

• Proficiency of personnel.
• Stability, integrity and reliability of
reagents .
• Equipment reliability,
• Specificity and sensitivity of tests .
• Use of appropriate controls .
• Documentation .
• Assessment.
Components of Analytic phase
Monitor, evaluate and maintain this phase
for ensuring reliability of results. This can
be done by :
 Equipment – reliability and maintainence
 Examination procedures
 Quality of examination procedure
Equipment

• Proper installation
• Calibration
• Validation
• Regular maintainance
• Train the operator
Examination procedure

• Standard procedures
• In house – to be validated – references,
interlab comparisons
• Review of all procedures periodically
Analytical Errors
 Test system not calibrated
 Results reported when control results
out of range
 Improper measurements of specimens
and/or reagents
 Reagents prepared incorrectly
 Reagents stored inappropriately or used
after expiration date
 Dilution and pipetting errors
Post Analytical phase
 Results and data review
 Reports
 Interpretation
 Communicate reports to physician
 Storage of specimen
Post analytic activities
Review and evaluate the following:

 Accuracy and completeness of results and

reports
 Disposition of unacceptable specimens
 Referral specimens and their reports
 Corrected reports
Reporting of results
 Release of reports only to the authorized
person
 Timely release of provisional and final
report
 Any value which exceeds the normal limit
must be clearly published, understood and
verbally, electronically or printed form -
when, where, what and to whom was
reported - document it.
Result format:

 Name and address of lab

 Name of patient with gender
 Lab ID number
 Date and time of receipt of sample
 Type of sample
 Name of test requested
 Result with the units
 The normal or reference range of the test
 Interpretation and explanation of the value of result
 Value added textual comments
 Name of the person authorising the release of the
report
 Signature of the person releasing the report
Post-Analytical Error
 Transcription errors in reporting
 Report sent to the wrong location
 Report illegible
 Report not sent
Summary
 Pre-Analytical Errors
• 46 – 68.2%
• Insufficient sample.
• Sample condition.
• Sample handling.
• Incorrect Identification.
• Incorrect sample.
 Analytical Errors
• 7 – 13.3 %
• Equipment Malfunction
• Sample Mix up
• Interference
 Post-Analytical
• 18.5 – 47 %
• Reporting and
Interpreting
• Improper date entry