Self reported routines and procedures for the extra-analytical phase of laboratory practice in Croatia - cross-sectional survey study

Introduction: Extra-analytical phase is the source of most of the errors in laboratory practice. A cross-sectional survey study was per formed among members of Croatian Chamber of Medical Biochemists (CCMB) aimed to investigate the status of extra-analytical phase in Croatia. Materials and methods: Results we re collected from members of CCMB (N = 538) using anonymous questionnaire with 20 Likert scaled questions testing self-reported frequency (never = 1, rarely = 2, of ten = 3, always = 4) of procedures of the pre-analytical phase. Answers were expressed as average score ranging from 1.00 to 4.00 for all questions. Questions were further divided in three groups, which average score was calculated accordingly: criteria of acceptance of sample, procedures of phlebotomy, test results reporting. Question on recording of non conformities was separately evaluated. Results: The response rate was 27%. Subject were 93% women, 58% medical biochemists with master degree and 42% specialist in medical biochemistry. Type of institution and informatics skills were also recorded. The average overall score was (mean +/- standard deviation) 3.12 +/- 0.38. There was no difference regarding type of laboratory institution, professional degree or computer skills and no cor relation be tween score and age. Procedures of phlebotomy score (2.83 +/- 0.46) achieved the lowest (P < 0.001) out of the three scores calculated (criteria of acceptance of sample: 3.33 +/- 0.49; reporting of results 3.19 +/- 0.48). Twenty one percent of participants never or rarely record non conformities, whereas 79% of ten or always do. Conclusion: Results clearly highlight the urgent need for improving activities in the extra-analytical phase, especially phlebotomy procedures. Reinforced education of all the personnel involved, appropriate recording and monitoring of extra-analytical phase is necessary to reach high quality standards.