Question

 Identify 3-5 scholarly research articles (published within the last 5 years) that address this exact issue or a similar issue in your or a similar population/setting. If a systematic/literature review exists on the topic, please include it among the articles.

 Topic: Lab errors

Answer 1

Ans) Laboratory testing is a highly complex process and, although laboratory services are relatively safe, they are not as safe as they could or should be.

- Clinical laboratories have long focused their attention on quality control methods and quality assessment programs dealing with analytical aspects of testing. However, a growing body of evidence accumulated in recent decades demonstrates that quality in clinical laboratories cannot be assured by merely focusing on purely analytical aspects.

- The more recent surveys on errors in laboratory medicine conclude that in the delivery of laboratory testing, mistakes occur more frequently before (pre-analytical) and after (post-analytical) the test has been performed.

- Most errors are due to pre-analytical factors (46-68.2% of total errors), while a high error rate (18.5-47% of total errors) has also been found in the post-analytical phase. Errors due to analytical problems have been significantly reduced over time, but there is evidence that, particularly for immunoassays, interference may have a serious impact on patients.

- A description of the most frequent and risky pre-, intra- and post-analytical errors and advice on practical steps for measuring and reducing the risk of errors is therefore given in the present paper. Many mistakes in the Total Testing Process are called "laboratory errors", although these may be due to poor communication, action taken by others involved in the testing process (e.g., physicians, nurses and phlebotomists), or poorly designed processes, all of which are beyond the laboratory's control.

- Likewise, there is evidence that laboratory information is only partially utilized. A recent document from the International Organization for Standardization (ISO) recommends a new, broader definition of the term "laboratory error" and a classification of errors according to different criteria.

- In a modern approach to total quality, centered on patients' needs and satisfaction, the risk of errors and mistakes in pre- and post-examination steps must be minimized to guarantee the total quality of laboratory services.

- Patient safety emphasizes the reporting, analysis, and prevention of medical errors that often lead to adverse events. Besides carrying serious harms to patient health, medical errors translate into a huge amount of money wiped out of the national and international economy.

- Significant progress has been made since the release of “To Err is Human.” Basically what has changed is the willingness to recognize the challenge and not argue about the numbers, but appreciate care must be safe always and everywhere for each patient.

- This has led to remarkable changes in the culture of health care organizations, so medical errors can no longer be seen as inevitable, but as something that can be actively streamlined and prevented.