A study that was published in 2002 concluded that the majority of laboratory errors occur in the preanalytic phase of testing.*
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
- Nerve or tissue damage caused by improper technique or wrong-site venipuncture
- Requisition errors
- Patient information missing, illegible, or on wrong patient
- Wrong tests ordered
- Patient identification
- Patient incorrectly identified
- Specimen not labeled or incorrectly labeled
- Specimen integrity
- Not enough specimen for testing
- Visible hemolysis
- Inadequate cleansing of venipuncture site resulting in contamination during blood culture collection
- Specimen centrifuged too long or not long enough
- Specimen placed in improper preservative
- Specimen transported at the wrong temperature (eg, specimen that should be placed on ice immediately after collection is transported at ambient temperature)
- Shipment of specimen
- Shipped at ambient temperature when it should have been shipped frozen
- Delay in shipment
- Order entry
- Incorrect data entered during manual entry of a test requisition
