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Preanalytic Phase

The preanalytic phase of testing includes all processes prior to the actual testing of a specimen. A study that was published in 2002 concluded that 68 - 87% of laboratory errors occur in the preanalytic and postanalytic stages of the testing process with the majority occurring in the preanalytic phase.*

Steps in the preanalytic phase occur both inside and outside the laboratory, and are performed by both laboratory and non-laboratory personnel. While the following list is not exhaustive, some of the most common sources of error in the preanalytic phase include:

  • Patient preparation
    • Patient not told to be fasting; improper or no instruction to patient on proper collection of specimen such as clean catch urine.
  • Patient injured during phlebotomy
    • Development of hematoma resulting in no specimen obtained for testing.
  • Requisition errors
    • Patient information missing, illegible, or on wrong patient; wrong tests ordered.
  • Patient identification
    • Patient incorrectly identified.
  • Labeling of specimen
    • Specimen not labeled or incorrectly labeled.
  • Preparation of specimen
    • Specimen centrifuged too long or not long enough; specimen placed in improper preservative.
  • Storage of specimen
    • Specimen not refrigerated or frozen as required or refrigerated when it should be at ambient temperature.
  • Shipment of specimen
    • Shipped at ambient temperature when it should have been shipped frozen; delay in shipment.
  • Accessioning process including preparation for analysis
    • Sorted into wrong batch; incorrect labeling.
  • Order entry
    • Incorrect data entered during manual entry of a test requisition.
  • Specimen sub-optimal
    • Not enough specimen for testing; visible hemolysis.
  • Contamination
    • Inadequate cleansing of venipuncture site resulting in contamination during blood culture collection.

*Reference: Bonini P, Plebani M, Ceriotti F, Rubboli F. Errors in laboratory medicine. Clin Chem. 2002;48:691-698. Available at Accessed February 16, 2016