Preanalytical Complications Causing Medical Errors in Blood Collection

The preanalytical (before analysis) phase of the testing process begins when a test is ordered and ends when testing begins. Each test in this process can lead to errors that will affect specimen quality and ultimately lead to erroneous results. In addition to having the technical skills to perform phlebotomy, it is also vital that the phlebotomist has a clear understanding of other variables that can affect the quality of a specimen before analysis.

This resource discusses some of these variables relating to the preanalytical process.

After completing this resource, learners will be able to:

• Describe preanalytical complications related to phlebotomy procedures and how they impact patient safety
• Explain how you should prevent and/or handle complications in blood collection
• List at least five factors about a patient's physical disposition that can affect blood collection
• List examples of substances that can interfere in a clinical analysis of blood constituents and describe methods used to prevent these interferences
• Describe how allergies, a mastectomy, edema, and thrombosis can affect blood collection
• List preanalytical complications that can arise with test requests and identification
• Describe complications associated with tourniquet pressure and fist pumping
• Describe how the preanalytical factors of syncope, petechiae, neurological complications, hemoconcentration, hemolysis, and intravenous therapy affect blood collection, and methods used to prevent these interferences