ASSESSING THE QUALITY PERFORMANCE IN PRE-ANALYTICAL PHASE OF HAEMATOLOGY AND SEROLOGY SAMPLES AT KIBOGORA DISTRICT HOSPITAL, RWA

Abstract

Clinical laboratory results are critical components of the patient management process, affecting treatment decisions as many as 70% of medical cases. Delayed or incorrect laboratory results resulting from poor sample quality constitutes a potential factor that leads to delayed or erroneous diagnosis, thus treatments. The purpose of the present study was to assess quality performance in pre-analytical phase of haematology and serology samples at Kibogora district hospital. Specific objectives of the study were: (1) to describe best practices during pre-analytical phase for haematology and serology sample processing at Kibogora District Hospital, Rwanda; and (2) to identify potential errors during pre-analytical phase for haematology and serology sample processing at Kibogora District Hospital, Rwanda. A quantitative approach and descriptive survey design were used in this study to collect data by use of a checklist for laboratory performance and questionnaire to survey nurses. The number of respondents was 72 nurses, and 165 samples were observed. Over half of nurse participants were females, 38 (52.8%) and males were 34 (47.2%). Education categories were Advanced diploma, 27(37.5%), and Bachelor degree45 (62.5%). Identified best practices were that all nurses, 72 (100%) had good knowledge on correct patient, correct test request, correct request form, correct container for haematology and serology samples, correct labelling, correct volume for haematology and serology samples, correct storage of haematology and serology samples and correct sample transportation. However, there were gaps in providing trainings, SOPs, and quality assurance evaluation by laboratory staff, 23(31.9%), 21(29.2%), and1.4%respectively. In laboratory all 165 samples that were observed, the laboratory technicians had best practices at 100% adherence to standards of checking patient identification, requested tests, right patient sample and labelling of sample. Gaps were on mention of the physician‟s name,25(15%), origin of sample 10(6%), sample collection date and time 50(30%), appropriateness of the container10 (6%), sufficiency of the sample 45(27%), ratio of blood and anticoagulant 50(30%), clotting of sample 45 (27%), haemolysis of sample 60(36%), proper storage 40(24%) and proper transportation 40(24%). In the light these results, intentions to improve the quality of laboratory technicians are recommended. Moreover, nurses need to keep their good performance through regular trainings.