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Total Clinical Chemistry Laboratory Errors and Evaluation of the Analytical Quality Control Using Sigma Metric for Routine Clinical Chemistry Tests

Authors Teshome M, Worede A, Asmelash D

Received 14 October 2020

Accepted for publication 6 January 2021

Published 15 January 2021 Volume 2021:14 Pages 125—136


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Dr Scott Fraser

Mulugeta Teshome,1 Abebaw Worede,2 Daniel Asmelash2

1Department of Medical Laboratory, Dessie Comprehensive Specialized Hospital, Dessie, Ethiopia; 2Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia

Correspondence: Daniel Asmelash
Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O Box 196, Gondar, Ethiopia

Background: Currently, the use of clinical laboratory tests is growing at a promising rate and about 80% of the clinical decisions made are based on the laboratory test results. Therefore, it is a major task to achieve quality service. This study was conducted to assess the magnitude of errors in the total testing process of Clinical Chemistry Laboratory and to evaluate analytical quality control using sigma metrics.
Methods: A cross-sectional study was conducted at Dessie Comprehensive Specialized Hospital Clinical Chemistry Laboratory, Northeast Ethiopia, from 10 February 2020 to 10 June 2020. All Clinical Chemistry Laboratory test requests with their respective samples, external quality control and all daily internal quality control data during the study period were included in the study. Data were collected using a prepared checklist and analyzed using SPSS version 21.
Results: A total of 4719 blood samples with their test requests were included in the study. Out of 145,383 quality indicators, an error rate of 22,301 (15.3%) was identified in the total testing process. Of the total errors, 76.3% were pre-analytical, 2.1% were analytical and 21.6% were post-analytical errors (p< 0.0001). Of the total 14 analytes in the sigma metric evaluation, except ALP, all routine clinical chemistry tests were below the standard (< 3). In multivariate logistic regression, the location of patients in the inpatient department was significantly associated with the specimen rejection ((AOR=1.837, 95% CI (1.288– 2.618), p=0.001).
Conclusion: The study found a higher frequency of errors in the total testing process in the Clinical Chemistry Laboratory and almost all test parameters had an unsatisfactory sigma metric value.

Keywords: analytical errors, Clinical Chemistry Laboratory, post-analytical errors, pre-analytical errors, sigma metrics, Ethiopia

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