QUALITY ASSESSMENT IN THE PRE-ANALYTICAL PHASE OF THE CLINICAL BIOCHEMISTRY LABORATORY OF A HOSPITAL IN RECIFE-PERNAMBUCO: A COST REPORT
DOI:
https://doi.org/10.47820/recima21.v5i6.5407Keywords:
Pre-analytical error. Clinical biochemistry. CostsAbstract
Around 70% of medical diagnoses depend on the results of laboratory tests, influencing decisions about admission, hospital discharge, and treatment of patients, making it essential to assess the quality of diagnostic tests. Pre-analytical errors occur in the steps before sample analysis, such as requesting, collecting, transporting, and receiving in the laboratory, and can cause delays in clinical management and increased costs. The study aimed to evaluate pre-analytical quality in a biochemistry laboratory, correlating them with direct input costs. It is characterized as cross-sectional and descriptive research, using primary and secondary data to account for expenses caused by pre-analytical errors. The clinical biochemistry sector of the studied hospital was responsible for 70% of the tests carried out in the laboratory in 2018 and 2019. Results demonstrate that the quality of the collection carried out by professionals external to the laboratory resulted in 501 samples discarded without analysis. A high prevalence of tubes collected in excess was also detected, representing 77% of total costs. 15,751 samples from glycated hemoglobin tests were analyzed, of which 308 were collected more than four times, which is higher than the frequency recommended by the Brazilian Diabetes Society over twelve months. It was found that pre-analytical errors can represent a challenge mainly within the public health system, where laboratory accreditation programs are not commonly implemented, and the costs caused by these errors have a high prevalence in total health costs.
Downloads
References
AMBACHEW, S.; ADANE, K.; WOREDE, A.; MELAK, T.; ASMELASH, D.; DANTIE, S.; BAINES, H. W.; ABEBE, M.; BIADGO, B. Errors in the total testing process in the clinical chemistry laboratory at the University of Gondar Hospital, northwest Ethiopia. Ethiopian Journal of Health Sciences, Gondar, v. 28, n. 2, p. 235-244, mar. 2018. DOI: http://dx.doi.org/10.4314/ejhs.v28i2.15. DOI: https://doi.org/10.4314/ejhs.v28i2.15
ASHAKIRAN, S.; SUMATI, M. E.; MURTHY, N. K. A study of pre-analytical variables in clinical biochemistry laboratory. Clinical Biochemistry, v. 44, n. 10-11, p. 944–945, jul. 2011. DOI: https://doi.org/10.1016/j.clinbiochem.2011.05.003. DOI: https://doi.org/10.1016/j.clinbiochem.2011.05.003
ATAY, A.; DEMIR, L.; CUHADAR, S.; SAGLAM, G.; UNAL, H.; AKSUM, S.; ARSLAN, B.; OZKAN, A.; SUTCU, R. Clinical biochemistry laboratory rejection rates due to various types of preanalytical errors. Biochemia Medica, v. 24, n. 3, p. 376–382, 2014. DOI: https://doi.org/10.11613/BM.2014.040
CHAVES, C. D. Controle de qualidade no laboratório de análises clínicas. Jornal Brasileiro de Patologia e Medicina Laboratorial, Rio de Janeiro, v. 46, n. 5, p. 352–352, out. 2010. DOI: http://dx.doi.org/10.1590/S1676-24442010000500002. DOI: https://doi.org/10.1590/S1676-24442010000500002
CRISTINA, E.; ROCHA, B.; ALMEIDA, M. V. G.; LOPES, M. R. Necessidade de gerenciamento dos gastos com exames laboratoriais no Brasil. Revista de Educação da Universidade Federal do Vale do São Francisco, v. 8, n. 15, p. 112-128, 2018.
FENAD. Posicionamento oficial SBD, SBPC-ML, SBEM e FENAD 2017/2018. [S. l.]: Sociedade Brasileira de Diabetes, 2018. 36 p.
GREEN, S. F. The cost of poor blood specimen quality and errors in preanalytical processes. Clinical Biochemistry, v. 46, n. 13–14, p. 1175-1179, sept 2013. DOI: https://doi.org/10.1016/j.clinbiochem.2013.06.001. DOI: https://doi.org/10.1016/j.clinbiochem.2013.06.001
GUIMARÃES, A. C.; WOLFART, M.; BRISOLARA, M. L. L.; DANI, C. O Laboratório Clínico e os Erros Pré-Analíticos. Clinical & Biomedical Research, v. 31, n. 1, p. 66-72, nov. 2011.
HENRIKSEN, L. O.; FABER, N. R.; MOLLER, M. F.; NEXO, E.; HANSEN, A. B. Stability of 35 biochemical and immunological routine tests after 10 hours storage and transport of human whole blood at 21°C. Scandinavian Journal of Clinical and Laboratory Investigation, v. 74, n. 7, p. 603-610, may. 2014. DOI: https://doi.org/10.3109/00365513.2014.928940
LIPPI, G.; BECAN-MCBRIDE, K.; BEHÚLOVÁ, D.; BOWEN, R. A.; CHURCH, S.; DELANGHE, J.; GRANKVIST, K.; KITCHEN, S.; NYBO, M.; NAUK, M.; PALICKA, V.; PLEBANI, M.; SANDBERG, S.; SIMUNDIC, A. M. Preanalytical quality improvement: In quality we trust. Clinical Chemistry and Laboratory Medicine, v. 51, n. 1, p. 229–241, 2013. DOI: https://doi.org/10.1515/cclm-2012-0597. DOI: https://doi.org/10.1515/cclm-2012-0597
LUCENA, R A. Justificação médica na realização de exames de imagem: fatores de influência e informações clínicas mínimas. 2019. 89f. Dissertação (Mestrado em Engenharia de Produção) - Escola de Engenharia, Universidade Federal do Rio Grande do Sul, Porto Alegre, 2019.
MENEZES, E. G. B.; CUNHA, N. C. W.; NETO, R. M. Comparação da determinação da glicose sanguínea usando o tempo como variável. Newslab, Fortaleza, edição 100, 2010.
NYBO, M. et al. Sample transportation - an overview. Diagnosis, Berlin, v. 6, n. 1, p. 39–43, 2019. DOI: https://doi.org/10.1515/dx-2018-0051
PERUCCI, L. O.; MAGALHÃES, H. P. B.; BORGES, K. B. G. Interferências pré-analíticas da urinálise- MG, 2016.
PLEBANI, M. Appropriateness in programs for continuous quality improvement in clinical laboratories. Clínica Chimica Acta, v. 333, n. 2, p. 131–139, 2003. DOI: https://doi.org/10.1016/S0009-8981(03)00177-3. DOI: https://doi.org/10.1016/S0009-8981(03)00177-3
PLEBANI, M. Exploring the iceberg of errors in laboratory medicine. Clínica Chimica Acta, v. 404, n. 1, p. 16–23, june. 2009. DOI: https://doi.org/10.1016/j.cca.2009.03.022. DOI: https://doi.org/10.1016/j.cca.2009.03.022
PLEBANI, M.; Sciacovelli, L.; AITA, A.; CHIOZZA, M. L. Harmonization of pre-analytical quality indicators. European Journal of Clinical Pharmacology, v. 24, n. 1, p. 105–130, 2014. DOI: https://doi.org/10.11613/BM.2014.012. DOI: https://doi.org/10.11613/BM.2014.012
PLEBANI, M.; CHIOZZA, M. L.; SCIACOVELLI, L. Towards harmonization of quality indicators in laboratory medicine. Clinical chemistry and laboratory medicine, v. 51, n. 1, p. 187–195, jan. 2013. DOI: https://doi.org/10.1515/cclm-2012-0582. DOI: https://doi.org/10.1515/cclm-2012-0582
SBPC/ML, Recomendações da Sociedade Brasileira de Patologia Clínica/Medicina Laboratorial. Gestão da Fase Pré-Analítica. Barueri, SP: Manole, 2012. 256 p.
UNICAMP - UNIVERSIDADE ESTADUAL DE CAMPINAS. Exames complementares. Campinas: Unicamp, 2011. Disponível em: http://www.fop.unicamp.br/ddo/patologia/downloads/db301_un1_ExamesComple.pdf. Acesso em: 20 jan. 2024.
VIEIRA, K. F.; SHITARA, E. S.; MENDES, M. E.; SUMITA, N. M. A utilidade dos indicadores da qualidade no gerenciamento de laboratórios clínicos. Jornal Brasileiro de Patologia e Medicina Laboratorial, Rio de Janeiro, v. 47, n. 3, p. 201-210, jun. 2011. DOI: http://dx.doi.org/10.1590/S1676-24442011000300002. DOI: https://doi.org/10.1590/S1676-24442011000300002
Downloads
Published
How to Cite
License
Copyright (c) 2024 RECIMA21 - Revista Científica Multidisciplinar - ISSN 2675-6218
This work is licensed under a Creative Commons Attribution 4.0 International License.
Os direitos autorais dos artigos/resenhas/TCCs publicados pertecem à revista RECIMA21, e seguem o padrão Creative Commons (CC BY 4.0), permitindo a cópia ou reprodução, desde que cite a fonte e respeite os direitos dos autores e contenham menção aos mesmos nos créditos. Toda e qualquer obra publicada na revista, seu conteúdo é de responsabilidade dos autores, cabendo a RECIMA21 apenas ser o veículo de divulgação, seguindo os padrões nacionais e internacionais de publicação.
Clique para ver detalhes 
