RESUMO
Introduction: Efficient laboratory services are the basis of modern health systems. Scientific innovations have contributed to substantial improvements in the laboratory environment, but errors still persist. These errors are classified as pre-analytical, analytical and post-analytical, according to the time of occurrence. Objective: To evaluate the frequency of pre-analytical errors in the clinical laboratory service of a military hospital. Methods: A total of 329,582 tests were performed in the clinical laboratory of Hospital Naval Marcílio Dias (HNMD) from August to October 2012, and pre-analytical errors were documented. Results: The most frequent cause of the observed pre-analytical errors was hemolysis (27.54%), followed by samples not received (25.43%) and insufficient sample volume (18.49%). The samples from the Integrated Home Care Service (SIAD) showed the highest frequency of errors (3.38%), followed by those from the inpatient (0.76%) and the outpatient departments (0.21%). Conclusion: Our study demonstrates the importance of managing laboratory pre-analytical quality in order to ensure service excellence...
Introdução: Serviços laboratoriais efetivos são a base dos sistemas de saúde modernos. Inovações científicas têm contribuído para melhorias substanciais no meio laboratorial, mas os erros ainda persistem. Esses erros são classificados como pré-analíticos, analíticos e pós-analíticos, dependendo do momento de sua ocorrência. Objetivo: Avaliar a frequência de erros pré-analíticos ocorridos no serviço de análises clínicas de um hospital militar. Métodos: Um total de 329.582 exames foram realizados no laboratório de análises clínicas do Hospital Naval Marcílio Dias no período de agosto a outubro de 2012, e os erros pré-analíticos documentados. Resultados: Os erros pré-analíticos mais observados foram decorrentes da hemólise (27,54%), seguidos de material não recebido (25,43%) e amostra insuficiente (18,49%). As amostras oriundas do Serviço Integrado de Atendimento Domiciliar (SIAD) foram as que apresentaram a maior frequência de erros (3,38%), seguidas pelo setor de pacientes internos (0,76%) e ambulatoriais (0,21%), respectivamente. Conclusão: Nosso estudo demonstra a importância da gestão da fase pré-analítica na garantia da qualidade laboratorial, de maneira a assegurar um serviço de excelência...
Assuntos
Humanos , Gestão da Qualidade Total , Indicadores de Serviços , Laboratórios Hospitalares/normas , Erros de Diagnóstico/estatística & dados numéricos , Laboratórios Hospitalares/organização & administração , Controle de QualidadeRESUMO
BACKGROUND: The optimal cryopreservation cell concentration during the peripheral blood stem cell (PBSC) collection is a controversial topic. We evaluated the influence of cryopreservation concentration on the recovery of hematopoietic progenitor cells and the kinetics of hematopoietic recovery of autologous stem cell transplant patients. STUDY DESIGN AND METHODS: In this retrospective study, we compared two different cryopreservation protocols: 1×10(8) cells/mL (Protocol A) and 2×10(8) cells/mL (Protocol B). A total of 419 PBSCs were analyzed with regard to the number of viable cells and colony-forming units-granulocytes-monocytes (CFU-GM) progenitors. The hematopoietic recovery of 275 patients who received PBSCs cryopreserved at a dose of 1×10(8) cells/mL (Group A) and 2×10(8) cells/mL (Group B) were compared. RESULTS: There were no significant differences in recovery of viable cells between Protocol A and Protocol B. The median of recovery of CFU-GM progenitors was significantly higher in Protocol B (41.2 vs. 57.3, p<0.01). The median times to neutrophil recovery (≥500×10(6) /L) and platelet (PLT) recovery (≥20×10(9) /L) in Groups A and B were 11 days versus 11 days and 12 days versus 12 days, respectively. However, by Kaplan and Meier analyses, Group B recovered neutrophils with a little delay (p=0.01). No difference was observed with regard to time to PLT recovery. On multivariate analysis, we found that the number of CD34+ cells and CFU-GM progenitors had a significant influence on hematopoietic recovery. CONCLUSION: Cryopreservation of PBSCs at a dose of 2×10(8) cells/mL did not affect the recovery rate of viable cells or the hematopoietic recovery of autologous stem cell transplant patients.
