Erros laboratoriais da fase pré-analítica e suas interferências no laudo laboratorial: uma revisão de literatura

Abstract

Laboratory medicine began centuries ago with urinalysis. With the advancement of technology, an undergraduate course called Biomedicine appears in higher education, where one of the various attributions of the professional is laboratory medicine. Despite all technological advances available today, the clinical analysis laboratory is prone to errors during the different phases of a laboratory exam, such as in the pre-analytical, analytical or post-analytical phase. These errors can often damage patient safety, as it is through their results that decisions are made for the diagnosis and treatment of diseases. According to the literature, the phase where most errors occur is the pre-analytical phase, accounting for up to 75% of the total. Thus, the objective of this research was to carry out a narrative literature review for a better understanding of the main laboratory errors committed during the pre-analytical phase of the laboratory test evolution, as well as their influence on the report released to the patient. Searches were performed from the bibliographic database of the National Library of Medicine of the United States of America (MEDLINE) through PubMed, on the website operated by the Anglo-Dutch publisher Elsevier through ScienceDirect and also on the Online Scientific Electronic Library, via SciELO. Initial searches of bibliographic databases retrieved a total of 347 articles. Of these, 173 were excluded by title, 122 declined by abstract and 24 by full text analysis, thus accounting for a total of 26 articles compatible with the research objective. Among the informational errors, the most common is the identification of samples, mentioned in 80.7% of the articles. For errors related to pre-collection actions, the most frequent is the inadequate preparation of the patient, mentioned in 61.53% of the researched articles. Errors related to the quality of the samples are the most frequent, such as an insufficient sample (88.45% incidence) followed by a hemolyzed sample, mentioned in 84.61% of the articles. Laboratory errors in the pre-analytical phase are generally linked to human errors, which can be corrected and greatly affect the quality of the laboratory report.