Magnitude of extra-analytical errors and associated factors in medical laboratories in thirteen Public Hospitals in Addis Ababa, Ethiopia

Abstract

Background: Currently, more than two-thirds of medical decisions are made based on laboratory test results. However, due to the compromised pre-analytical and post-analytical phases (or extra-analytical phase), the reporting of incorrect or inappropriate test results was still prevalent. Studies focusing on the prevalence of and factors associated with laboratory error remain very limited in Ethiopia. Objective: This study aimed to assess the magnitude of extra-analytical errors and associated factors in medical laboratory services in 13 public hospitals in Addis Ababa, Ethiopia, from January to April 2020. Materials and Methods: A hospital-based cross-sectional study was conducted in the medical laboratories of public hospitals in Addis Ababa from January to April 2020 to assess extra-analytical errors and associated factors. Data were collected from 2401 laboratory request forms ordered within the study period and 169 laboratory professionals working in public hospitals. The collected data were entered and analyzed using SPSS version 23 software. Data were analyzed using simple descriptive statistics, percentages, and frequencies and summarized using tables and text. Bivariate logistic regression analysis was conducted, and variables (with a p value below 0.25) were included in the multivariate logistic regression model. A p value <0.05 was considered a cutoff point in the final model. Results: In this study, of the errors detected, 60.3% occurred in the pre-analytical phase and 39.7% in the post-analytical phase. Extra-analytical errors in laboratory services were significantly associated with lack of written procedures for laboratory activities (adjusted odds ratio = 2.79, 95% confidence interval = 1.34–5.86), 1–2 years of work experience (adjusted odds ratio = 5.5, 95% confidence interval = 2.54–9.31), work experience (3–5 years) (adjusted odds ratio = 2.67, 95% confidence interval = 0.94–4.56), and education (diploma) (adjusted odds ratio = 6.30, 95% confidence interval = 2.17–12.26). Conclusion: This study discovered errors in the pre-analytical (60.3%) and post-analytical (39.7%) phases, and none of the requisition papers had complete data. This frequency may be affected by workload, a lack of written procedures, the number of years of work experience, and the level of education of the staff.