Compliance with the clinical laboratory quality protocol in public primary healthcare centres

Abstract

The clinical and economic relevance of the clinical laboratories procedures in Andalusia (Spain) have led the Regional Department of Health to focus attention on their improvement. A unified laboratory protocol was implemented that consisted of the unification of criteria in the handling and processing of samples, and report of results. The objective of this study is to describe the degree of compliance with the clinical laboratory protocol in the preanalytical phase, which includes the analytical request and up to the delivery in the laboratory, as well as the influencing factors. Cross-sectional descriptive study with a sample of 214 healthcare professionals involved in the preanalytical phase of laboratory procedures in primary care. A self-reported questionnaire with 11 items was used for data collection. Each item was assessed separately with a scale from 0 to 10. A 5 points score was considered as the cutoff point. Descriptive analysis was conducted and Mann-Whitney U test was used to determine differences between subgroups. Internal consistency of the questionnaire was considered. The best rated item was verifying the correspondence between the request form and identity of the patient. Each item scored from 3 to 10, and the mean for each item ranged from 6.40 (standard deviation = 3.06) to 8.57 (standard deviation = 2.00). Values above or equal to 8 were obtained, for 63.6% of them. Statistically significant differences between accredited and nonaccredited centres were found. Differences were not noteworthy regarding centres with a teaching activity or those without it. All the items were measured separately. The compliance with the protocol was adequate among primary healthcare professionals, who have a strategic position in the sample collection and its transport during the preanalytical phase. Being so, standardisation should be a priority to reduce errors and improve clinical safety and results.