Reduction of preanalytical errors in laboratory by establishment and application of training system

Errors in preanalytical phase occupied for almost half of total errors in clinical laboratory, and the causes are related to medical staff's quality awareness and behaviors. In order to reduce the preanalytical errors in our hospital, we established and applied a training system to improve the situation.

The disqualified sample types and major causes of errors in the preanalytical phase were investigated in clinical laboratory department from September 2008 to August 2009. In the following year, we established and applied a training system to affect the quality awareness and behaviors of medical staff. Questionnaire investigation was analyzed to illustrate the changes of respondents' quality awareness and behavior, and the preanalytical errors were reanalyzed according to different departments to evaluate the effects of the intervention measures.

The total disqualification rate in the preanalytical phase obtained from September 2008 to August 2009 was 1.36%, and the major types of disqualified samples were coagulation of anticoagulant sample, sample inadequacy, sample container error, sample information error, and sample type error. After application of established training system, respondents' quality awareness on preanalytical samples changed dominantly, and respondents' own behavior and behavior to others also changed notably. The total disqualification rate in preanalytical phase dropped to 0.94%, among 33 clinical departments, the preanalytical errors in 25 departments decreased to various degrees, and 10 departments had overall decreasing amplitude over 50%.

The overall effect of the application of established training system is very good, and the disqualification rate of the major departments decrease to various degrees.