Publication: Determination of errors that compromise the quality of clinical chemistry laboratory service delivery at Kenyatta National Hospital
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2016-10
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Mount Kenya University
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Abstract
The study established the level of pre-analytical, analytical, and post analytical errors found in
the analysis of Clinical Chemistry Laboratory specimen at Kenyatta National Hospital, Kenya.
This study adopted a descriptive survey design as the main approach and targeted 346 sampled
specimens and request forms received. All the laboratory request forms, specimens/samples and
dispatch of results were scrutinized and errors documented as per the different variables in the
different phases, over a period of three months in the Clinical Chemistry Laboratory. The study
aimed at establishing the levels of laboratory errors in all the phases. Results of the study showed
that Preanalytical errors were most common with a frequency of 148(42.8%), statistically
significant (P < 0.0001),followed by analytical errors 114 (32.9%), statistically significant
difference (Chi-square, 155.5; df, 1; P < 0.0001), and post analytical errors 84 (24.3%), There
was a statistically significant difference (Chi-square, 198.4; df, 1; P < 0.0001) . Preanalytical
errors found included request forms lacking address, tests not done in clinical chemistry
laboratory, specimen drawn in wrong tube and specimen without request forms , while analytical
errors found include reagent out of stock , inadequate sample during test runs , haemolyzed
samples and double registration of specimen, and lastly is the post analytical errors found the
following uncollected results, critical values not communicated results lost and unreviewed
results. Clinical Laboratory error reduction, prevention and high quality laboratory service
delivery requires team work, involving collaboration, coordination and effective communication
among all health care workers. The study concludes that the development and adherence to
standard operating procedures will minimize this errors, forecasting of reagents and critical
results to be communicated immediately to the respective clinics or ward Team leaders for
prompt action, the study also recommends that there is need for routine, schedule Clinical
laboratory audits and implementation of Laboratory information system towards quality
laboratory service delivery.
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Clinical Chemistry Laboratory