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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter


IMPACT FACTOR 2018: 3.638

CiteScore 2018: 2.44

SCImago Journal Rank (SJR) 2018: 1.191
Source Normalized Impact per Paper (SNIP) 2018: 1.205

Online
ISSN
1437-4331
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Volume 47, Issue 2

Issues

Causes, consequences, detection, and prevention of identification errors in laboratory diagnostics

Giuseppe Lippi
  • 1Clinical Chemistry Laboratory, University of Verona, Verona, Italy, EPSC – European Preanalytical Scientific Committee (www.specimencare.com) and International Federation of Clinical Chemistry Working Group on Patient's Safety
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Norbert Blanckaert
  • 2EPSC – European Preanalytical Scientific Committee (www.specimencare.com) and Laboratory Medicine, University Hospital Leuven, Leuven, Belgium
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Pierangelo Bonini
  • 3EPSC – European Preanalytical Scientific Committee (www.specimencare.com), International Federation of Clinical Chemistry Working Group on Patient's Safety and Clinical Biochemistry, School of Medicine, University Vita-Salute San Raffaele, Milano, Italy
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Sol Green
  • 4EPSC – European Preanalytical Scientific Committee (www.specimencare.com) and BD Diagnostics – Preanalytical Systems, New Jersey, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Steve Kitchen
  • 5EPSC – European Preanalytical Scientific Committee (www.specimencare.com) and Sheffield Hemophilia and Thrombosis Center, Royal Hallamshire Hospital, Sheffield, UK
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Vladimir Palicka
  • 6EPSC – European Preanalytical Scientific Committee (www.specimencare.com) and Institute of Clinical Biochemistry and Diagnostics, Charles University, Medical Faculty and University Hospital, Hradec Kralove, Czech Republic
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Anne J. Vassault
  • 7EPSC – European Preanalytical Scientific Committee (www.specimencare.com) and Laboratoire de Biochimie B, Hôpital Necker Enfants Malades, APHP, Paris, France
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Camilla Mattiuzzi / Mario Plebani
  • 9International Federation of Clinical Chemistry Working Group on Patient's Safety and Department of Laboratory Medicine, University of Padova, Padova, Italy
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2008-12-22 | DOI: https://doi.org/10.1515/CCLM.2009.045

Abstract

Laboratory diagnostics, a pivotal part of clinical decision making, is no safer than other areas of healthcare, with most errors occurring in the manually intensive preanalytical process. Patient misidentification errors are potentially associated with the worst clinical outcome due to the potential for misdiagnosis and inappropriate therapy. While it is misleadingly assumed that identification errors occur at a low frequency in clinical laboratories, misidentification of general laboratory specimens is around 1% and can produce serious harm to patients, when not promptly detected. This article focuses on this challenging issue, providing an overview on the prevalence and leading causes of identification errors, analyzing the potential adverse consequences, and providing tentative guidelines for detection and prevention based on direct-positive identification, the use of information technology for data entry, automated systems for patient identification and specimen labeling, two or more identifiers during sample collection and delta check technology to identify significant variance of results from historical values. Once misidentification is detected, rejection and recollection is the most suitable approach to manage the specimen.

Clin Chem Lab Med 2009;47:143–53.

Keywords: errors; laboratory medicine; misidentification; patient identification; patient safety

About the article

Corresponding author: Prof. Giuseppe Lippi, MD, Sezione di Chimica e Microscopia Clinica, Dipartimento di Scienze Morfologico-Biomediche, Università degli Studi di Verona, Ospedale Policlinico G.B. Rossi, Piazzale Scuro, 10, 37134 Verona, Italy Phone: +39-045-8124308, Fax: +39-045-8201889, ,


Received: 2008-07-16

Accepted: 2009-11-25

Published Online: 2008-12-22

Published in Print: 2009-02-01


Citation Information: Clinical Chemistry and Laboratory Medicine, Volume 47, Issue 2, Pages 143–153, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2009.045.

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