Raccomandazioni per la rilevazione e gestione dei campioni non idonei nei laboratori clinici

A large body of evidence attests that quality improvement programs targeted at the sole analytical phase would not grant additional clinical and economical outcomes, since the large majority of errors encountered in clinical laboratories occurs in the extra-analytical areas of testing, especially in manually-intensive preanalytical processes. Most preanalytical errors result from system flaws and insufficient audit with the operators involved in specimen collection and handling responsibilities, leading to an unacceptable number of unsuitable specimens due to misidentification, in vitro hemolysis, clotting, insufficient volume, wrong container and contamination. Detection and management of unsuitable samples are therefore necessary conditions to overcome this unwelcome variability. The present document, issued by the Italian intersociety SIBioC-SIMeL-CISMEL study group on the extra-analytical variability is aimed to review the major causes of unsuitable specimens in clinical laboratories, providing consensus recommendations on detection and management.