Medical laboratories need to develop and maintain quality management processes as part of the ISO15189 accreditation. This is to maintain quality standards for the pre-analytical phase, the analytical phase and the post-analytical phase. The pre-analytical phase often requires transportation of blood samples, which must happen under predefined circumstances to preserve the integrity of the blood samples.
So what needs to be considered? What is the potential effect on blood samples when in temporary, transit storage?
The influence of time and temperature on blood samples in transit
The Association for Clinical Biochemistry & Laboratory Medicine wanted to understand better the effects of temporary storage and transport on samples. The result was a study of 48 routine whole blood samples. The aim of this study was to determine the inﬂuence of temperature and time in whole blood on the stability of commonly requested analytes.
What were the findings and what does this mean for the safe storage and transportation of samples? In their 2017 paper, Effects of time and temperature on 48 routine chemistry, haematology and coagulation analytes in whole blood samples, they established that some analytes in blood samples are particularly susceptible to temperature variances. Notably LDH, K+, Na+, Ca2+ are all susceptible to low temperatures, having a deleterious effect on blood results. At higher temperatures (room temperature and above) bicarbonate measurements become unstable.
While very few tests were affected negatively by higher temperatures (with the exception of bicarbonate measurements) several were affected by lower temperatures. These variances could result in additional samples being required - an inconvenience with a detrimental impact on patient trust or, more worryingly, misdiagnosis of a patient’s condition, based upon spurious results.
The temperature of blood samples during transport is therefore a critical issue that could affect patient safety and accuracy of diagnoses.
This research underpins the clear need for monitoring of patient samples in transit.
Checkit has developed devices that allow temperature to be measured over time. When the samples arrive in the laboratory, the devices are able to generate a report, providing evidence of storage temperature during transit. As a result, the laboratory can be certain that the results are unaffected by temperature variances. And clinicians can be confident in the results from the laboratory.
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