Pre-analytical phase management: a review of the procedures from patient preparation to laboratory analysis

Abstract

The pre-analytical phase encompasses all the procedures before the start of laboratory testing. This phase of the testing process is responsible for the majority of the laboratory errors, since the related procedures involve many sorts of non-laboratory professionals working outside the laboratory setting, thus without direct supervision by the laboratory staff. Therefore, either correct organization or management of both personnel and procedures that regard blood specimen collection by venipuncture are of fundamental importance, since the various steps for performing blood collection represent per se sources of laboratory variability. The aim of this (non-systematic) review addressed to healthcare professionals is to highlight the importance of blood specimen management (from patient preparation to laboratory analyses), as a tool to prevent laboratory errors, with the concept that laboratory results from inappropriate blood specimens are inconsistent and do not allow proper treatment nor monitoring of the patient.

Keywords:

• Blood specimen collection
• clinical laboratory techniques
• patient safety
• quality control
• total quality management

Acknowledgements

We thank the journals Biochemia Medica (ISSN 1330-0962) and Lab Medicine (ISSN 0007-5027), for granting permission to publish the data presented in Tables 1 and 2, respectively; Blood Transfusion (ISSN 1723-2007) and Annals of Laboratory Medicine (ISSN 2234-3814) for granting permission to publish the data presented in Figure 1, International Journal of Laboratory Hematology (ISSN 1751-553X) and Blood Transfusion (ISSN 1723-2007) for granting permission to publish the data presented in Table 3. All these data were previously published and are internationally copyrighted (i.e. references 9, 13, 14, 45, 50, 57). This review article is an integral part of GLO PhD thesis. We would like to thank CAPES Foundation, Ministry of Education of Brazil, Brasília – DF, Brazil for supporting GLO PhD thesis.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.