Observational Assessment of Pre-Analytical Errors in Request Format and Phlebotomy Practice in Hematology Tests at Hawassa University Comprehensive Specialized Hospital in Sidama Zone, Southern Ethiopia

Abstract

Background: The significance of quality in laboratories necessitates the implementation of comprehensive quality management throughout the entire laboratory process, encompassing the pre-analytical to post-analytical phases. The pre-analytical phase, which plays a crucial role in laboratory services, is particularly significant, as it is responsible for approximately 70% of errors. Enhancing the quality of the pre-analytical phase is essential to ensure the effectiveness of laboratory services and safeguard patient safety. Objective: The objective of this study was to assess errors made in the request format and phlebotomy procedures during the collection of blood samples for hematology laboratory tests between April and June 2019. Methods: A cross-sectional study was carried out at Hawassa University College of Medicine and Health Sciences on 393 samples with their respective request forms. The study employed a systematic sampling technique and utilized well-structured checklists to gather all the necessary data for hematology laboratory tests, including a thorough evaluation of the requested form. Data analysis was performed using the Statistical Package for Social Sciences (SPSS) software version 21. Results: A total of 393 hematological samples from their respective request forms were analyzed in this study. Generally, the request forms did not contain all the necessary information, and each form had at least one error. The study also revealed the occurrence of pre-analytical errors in phlebotomy practice. These errors included prolonged tourniquet application (26.2%), improper identification (22.9%), inadequate cleaning of the vein puncture site (62.8%), unsafe needle removal and blood transfer to test tubes (6.6%), and improper mixing of collected blood samples (41.5%). Conclusion: The findings of this study revealed a substantial occurrence of pre-analytical errors in the hematology laboratory department. Therefore, it is crucial to prioritize the correct execution and utilization of phlebotomy procedures as well as request format to enhance quality assurance in hematology laboratory units.