title: Preanalytical mistakes in samples from primary care patients.
abstract: BACKGROUND
  Preanalytical mistakes (PAMs) in samples usually led to rejection upon arrival to the clinical laboratory. However, PAMs might not always be detected and result in clinical problems. Thus, PAMs should be minimized. We detected PAMs in samples from Primary Health Care Centres (PHCC) served by our central laboratory. Thus, the goal of this study was to describe the number and types of PAMs, and to suggest some strategies for improvement.
  
  
  METHODS
  The presence of PAMs, as sample rejection criteria, in samples submitted from PHCC to our laboratory during October and November 2007 was retrospectively analysed.
  
  
  RESULTS
  Overall, 3885 PAMs (7.4%) were detected from 52,669 samples for blood analyses. This included missed samples (n=1763; 45.4% of all PAMs, 3.3% of all samples), haemolysed samples (n=1408; 36.2% and 2.7%, respectively), coagulated samples (n=391; 10% and 0.7%, respectively), incorrect sample volume (n=110; 2.8% and 0.2%, respectively), and others (n=213; 5.5% and 0.4%, respectively). For urine samples (n=18,852), 1567 of the samples were missing (8.3%).
  
  
  CONCLUSIONS
  We found the proportion of PAMs in blood and urine samples to be 3-fold higher than that reported in the literature. Therefore, strategies for improvement directed towards the staff involved, as well as an exhaustive audit of preanalytical process are needed. To attain this goal, we first implemented a continued education programme, financed by our Regional Health Service and focused in Primary Care Nurses.
authors.affiliation: Clinical Laboratory, University Hospital Virgen de la Victoria, Málaga, Spain.
authors.forename: Adolfo
authors.initials: A
authors.lastname: Romero
authors.forename: Andrés
authors.initials: A
authors.lastname: Cobos
authors.forename: Ana
authors.initials: A
authors.lastname: López-León
authors.forename: Germán
authors.initials: G
authors.lastname: Ortega
authors.forename: Manuel
authors.initials: M
authors.lastname: Muñoz
mesh_terms: D019963:Clinical Chemistry Tests / Q000592:standards*; D003951:Diagnostic Errors; D006801:Humans; D011320:Primary Health Care