Principais erros na fase pré-analítica de exames bioquímicos: uma revisão sistemática

Abstract

The Clinical Laboratory is a healthcare facility that conducts activities related to clinical laboratory tests, encompassing the pre-analytical, analytical, and post-analytical phases. The pre-analytical phase includes the period from the medical request to the sample processing, being the longest phase and where the likelihood of errors that may lead to inaccurate results for the patient under analysis is higher. This study aims to perform a systematic review to deepen healthcare professionals' understanding of the most frequent errors in the pre-analytical phase of biochemical tests, providing an analysis of the currently available literature. A bibliographic search was conducted using the scientific databases PubMed, Google Scholar, and SciELO, as well as consulting reference books in the field of laboratory tests. Specific keywords were used, including pre-analytical phase; clinical laboratory; clinical analyses; quality control. A total of 22 studies published between 2011 and 2022 that addressed the topic were located. After compiling the information, it was observed that the most cited pre-analytical errors included informational errors, collection errors, hemolyzed, lipemic, and contaminated samples, and samples with inadequate blood/anticoagulant ratios. The analysis of the selected studies revealed that these errors can occur at various stages of the pre-analytical process, including collection, processing, and identification of biological samples, directly impacting the reliability and accuracy of laboratory results. Identifying these errors is of utmost importance for clinical laboratories as they significantly influence the quality of the reports issued and, consequently, the safety and effectiveness of medical diagnoses. Preventing these errors requires an approach that includes the continuous training and education of healthcare professionals, as well as the adoption of advanced technologies that ensure proper identification, handling, and storage of samples.