Laboratory Quality Control

The future of laboratory medicine: the researchers are looking for new possible sources of error in order to guarantee patient safety.

Nowadays important organization like World Health Organization – WHO and International Federation of Clinical Chemistry and Laboratory Medicine – IFFC are intensively working to decrease laboratory error thus guaranteeing patient safety. Many laboratory professionals think that to eliminate laboratory error is enough to make internal quality controls and proficiency tests. The problem is that most frequently errors in laboratory occur in extra-analytical phases (i.e. pre and post analytical). Moreover, there are only few routine procedures for the detection of non-conformities in this field of activity.

In the pre analytical phase the procedures involving phlebotomy, critical to the obtainment of diagnostic blood specimens, are poorly studied as regards the major sources of errors and the procedures related to quality control process.  From a practical point of view, the tourniquet-induced venous stasis promotes the exit of water, diffusible ions and low molecular weight substances from the vessel thereby increasing the concentration of various blood analytes at the punctured site thus potentially influencing the laboratory results interpretation. More so, when the vascular microenvironment is subjected to both hypoxia and concurrent stasis, accumulation of some bioproducts ensues such as the protons that have the potential to promote changes in laboratory parameters. Thus, the use of tourniquet has the potential to generate false positive results and prospectively induce the caring physicians to adopt undue treatments. On the contrary the trans-illumination is able to eliminate or greatly reduce these risks on haematological, biochemistry and coagulation laboratory tests.

The use of trans-illumination device, is based on cold near infrared light-emitting diodes (LEDs) whose light is absorbed by intra-erythrocyte haemoglobin flowing along the veins. During my PhD program I am presently dealing with the pre-analytical issues both at Verona University – Italy and at Federal University of Parana – Brazil. The work group consists of Prof Gian Cesare Guidi and Prof Giuseppe Lippi, Prof Martina Montagnana and Dr Gian Luca Salvagno and is helping me to identify the new source of error to guarantee the patient safety. I am very lucky because I am a young scientist and this very important work group has opened the doors to me. With this working group I learn, work and help to improve the patient safety. If Labs are vital, young scientist are essential to study new source of laboratory error to both guarantee the patient safety and improve the future of laboratory medicine!

More information on laboratory quality control.

References: Gabriel Lima-Oliveira Brazilian Society of Clinical Analyses on Sao Paulo State, Brazil & MERCOSUL: Sector Committee of Clinical Analyses and in Vitro Diagnostics

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