Posted in | Hematology

Preanalytical Errors in Blood Gas Testing

There is an increasing awareness of the impact of errors in medicine on the patient and on the entire healthcare system. It is estimated that as many as 98,000 people die annually in the USA as a result of preventable medical errors. This problem has been recognized by both World Health Organization (WHO) as well as by the European Commission (EC).

According to both WHO and EC data, one in ten patients experience some form of harm due to a medical error while receiving hospital care. Those data have triggered an increasing interest in quality improvement and patient safety in the healthcare profession over the past two decades with the aim of reducing the rate of adverse events, improving patient outcome, and decreasing the overall economical burden. Opportunities for improvement need to be identified and all stakeholders are responsible for action.

Up to 30 percent of errors in medicine may lead to diagnostic error in the form of delayed or missed diagnosis, or misdiagnosis. Evidence shows that while the total testing process is a significant source of diagnostic errors, up to 70% of those errors occur in the pre-analytical phase. Preanalytical errors are mostly related to the procedures performed outside of the lab and are not under the direct supervision of the laboratory personnel. However, ISO 15189 accreditation standard for medical laboratories recognizes the laboratory as the responsible party for monitoring and improving the preanalytical phase.

Blood gas testing is in many ways unique. Among the most prominent features of blood gas testing are the critical nature of the patient, invasive blood collection procedure and limited stability of the sample. Due to the low biological variability of many blood gas parameters, allowable total error is quite low and even small differences in serial measurements can be clinically meaningful. Since, blood gas testing is of vital importance for the critically ill patient, it is the healthcare professional's role to ensure that the right sample is taken from the right patient, at the right time, and that correct test result is provided to the ordering physician without delays. No result is always better than a bad result.

This webinar will review the steps in blood gas testing focusing on all possible sources or errors and error prevention opportunities, outline most critical characteristics related to the patient condition, blood collection procedure and sample stability, and provide recommendations for successful management of blood gas testing.


Ana-Maria Simundic, PhD, Prof. of Medical Biochemistry, Zagreb University, Croatia

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