CoChat
Sign Up
Cited by 18Clinical Laboratory Practices and Quality ControlHealthcare Quality and ManagementQuality and Safety in Healthcare

The DOI matches its Crossref record.

Preanalytical external quality assessment of the Croatian Society of Medical Biochemistry and Laboratory Medicine and CROQALM: finding undetected weak spots

Open access
Nikolac, Nora, Lenicek Krleza, Jasna, Simundic, Ana-Maria·2017·Biochemia Medica
DOI 10.11613/bm.2017.017PMC PMC5382847
Open this paper in CoChat — free accountOpen PDF

Abstract

INTRODUCTION: The aim of this paper is to present results of first two years of preanalytical external quality assessment (EQA) in Croatia. MATERIALS AND METHODS: This paper summarizes results from 6 rounds of preanalytical EQA during 2014-2016 in 161-175 Croatian laboratories (number ranged between cycles). EQA was designed as an online survey of the compliance with National recommendations for phlebotomy (NRP). Forty-seven questions in 5 categories are analyzed (materials and equipment, patient identification, patient preparation, sampling and storage). Additionally, preanalytical cases are presented. Overall performance scores (Question score (Qscore) for compliance with NRP and Case score (Cscore) for preanalytical cases) are calculated for each question/case as a proportion of laboratories with satisfactory procedure (x 100). Qscores and Cscores ≥ 70 were classified as acceptable (maximal score = 100). RESULTS: In investigation of compliance with NRP, acceptable Qscores were obtained for 34/47 questions. The lowest scores were observed for the availability of sterile disposable tourniquets (Qscore = 15) and safe-sharp needles (Qscore = 34), obtaining patients address as an identifier (Qscore = 21), using glycolysis inhibitor tubes for glucose concentration measurement (Qscore = 21) and verification of manufacturers declarations on temperature and time of storage (Qscore = 31). There was no statistically significant difference in overall Qscore according to different categories of phlebotomy procedures (P = 0.284). The results of preanalytical cases showed acceptable Cscore values for all cases (89-96). CONCLUSION: First two years of preanalytical EQA showed good compliance with the NRP and excellent expertise in resolving complex preanalytical issues. Major critical spots are lack of availability of safe-sharp needles, disposable tourniquets and glucose inhibitor tubes.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.11613/bm.2017.017

Cites

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

No references could be resolved yet.

Research works printed but not linked: 26

  1. [2]Kristensen GB, Aakre KM, Kristoffersen AH, Sandberg S. How to conduct External Quality Assessment Schemes for the pre-analytical phase? Biochem Med (Zagreb) 2014;24:114-22. https://doi.org/10.11613/BM.2014.013. PMC3936964 24627720 · DOI
  2. [3]Alsina MJ Alvarez V, Barba N, Bullich S, Cortés M, Escoda I, Martínez-Brú C. Preanalytical quality control program - an overview of results (2001-2005 summary). Clin Chem Lab Med. 2008; 46: 849– 54. 18601609
  3. [4]Llopis MA, Bauça JM, Barba N, Álvarez V, Ventura M, Ibarz M, et al. Spanish Preanalytical Quality Monitoring Program (SEQC), an overview of 12 years’ experience. Clin Chem Lab Med 2016. [Epub ahead of print]. 10.1515/cclm-2016-0382. 27658151 · DOI
  4. [5]Bilic-Zulle L, Simundic AM, Supak Smolcic V, Nikolac N, Honovic L. Self reported routines and procedures for the extra-analytical phase of laboratory practice in Croatia - cross-sectional survey study. Biochem Med (Zagreb) 2010;20:64-74. https://doi.org/10.11613/BM.2010.008. · DOI
  5. [6]Simundic AM Bilic-Zulle L Nikolac N Supak-Smolcic V Honovic L Avram S The quality of the extra-analytical phase of laboratory practice in some less developed European countries and Mexico – multicentric study. Clin Chem Lab Med. 2011; 49: 215– 28. 10.1515/CCLM.2011.034 10.1515/CCLM.2011.034 21118049 · DOI
  6. [7]Nikolac N, Šupak-Smolčić V, Šimundić AM, Ćelap I. Croatian Society of Medical Biochemistry and Laboratory Medicine: national recommendations for venous blood sampling. Biochem Med (Zagreb) 2013;23:242-54. https://doi.org/10.11613/BM.2013.031. PMC3900082 24266294 · DOI · Paper page
  7. [9]Rourke C Bates C Read RC Poor hospital infection control practice in venepuncture and use of tourniquets. J Hosp Infect. 2001; 49: 59– 61. 10.1053/jhin.2001.1038 10.1053/jhin.2001.1038 11516188 · DOI
  8. [10]Leitch A McCormick I Gunn I Gillespie T Reducing the potential for phlebotomy tourniquets to act as a reservoir for meticillin-resistant Staphylococcus aureus. J Hosp Infect. 2006; 63: 428– 31. 10.1016/j.jhin.2006.03.006 10.1016/j.jhin.2006.03.006 16759742 · DOI
  9. [11]Elhassan HA Dixon T MRSA contaminated venepuncture tourniquets in clinical practice. Postgrad Med J. 2012; 88: 194– 7. 10.1136/postgradmedj-2011-130411 10.1136/postgradmedj-2011-130411 22298685 · DOI
  10. [13]Tarigan LH Cifuentes M Quinn M Kriebel D Prevention of needle-stick injuries in healthcare facilities: a meta-analysis. Infect Control Hosp Epidemiol. 2015; 36: 823– 9. 10.1017/ice.2015.50 10.1017/ice.2015.50 25765502 · DOI
  11. [14]De Carli G, Abiteboul D, Puro V. The importance of implementing safe sharps practices in the laboratory setting in Europe. Biochem Med (Zagreb) 2014;24:45-56. https://doi.org/10.11613/BM.2014.007. PMC3936965 24627714 · DOI · Paper page
  12. [15]Hanmore E Maclaine G Garin F Alonso A Leroy N Ruff L Economic benefits of safety-engineered sharp devices in Belgium - a budget impact model. BMC Health Serv Res. 2013; 13: 489. 10.1186/1472-6963-13-489 10.1186/1472-6963-13-489 24274747 PMC4222860 · DOI
  13. [16]Simundic AM Church S Cornes MP Grankvist K Lippi G Nybo M Compliance of blood sampling procedures with CLSI H3-A6 standard for the collection of diagnostic blood specimens by venipuncture and risk assessment analysis: An observational study by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) working group for the preanalytical phase (WG-PRE). Clin Chem Lab Med. 2015; 53: 1321– 31. 10.1515/cclm-2014-1053 10.1515/cclm-2014-1053 25536667 · DOI
  14. [17]van Dongen-Lases EC Cornes MP Grankvist K Ibarz M Kristensen GB Lippi G Working Group for Preanalytical Phase (WG-PRE), European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Patient identification and tube labelling - a call for harmonisation. Clin Chem Lab Med. 2016; 54: 1141– 5. 10.1515/cclm-2015-1089 10.1515/cclm-2015-1089 26816400 · DOI · Paper page
  15. [18]Nikolac N Simundic AM Kackov S Serdar T Dorotic A Fumic K The quality and scope of information provided by medical laboratories to patients before laboratory testing: Survey of the Working Group for Patient Preparation of the Croatian Society of Medical Biochemistry and Laboratory Medicine. Clin Chim Acta. 2015; 450: 104– 9. 10.1016/j.cca.2015.08.001 10.1016/j.cca.2015.08.001 26253925 · DOI
  16. [20]Simundic AM Cornes M Grankvist K Lippi G Nybo M Standardization of collection requirements for fasting samples: for the Working Group on Preanalytical Phase (WG-PA) of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM). Clin Chim Acta. 2014; 432: 33– 7. 10.1016/j.cca.2013.11.008 10.1016/j.cca.2013.11.008 24269503 · DOI · Paper page
  17. [21]Guidi GC Simundic AM Salvagno GL Aquino JL Lima-Oliveira G To avoid fasting time, more risk than benefits. Clin Chem Lab Med. 2015; 53: e261– 4. 10.1515/cclm-2014-1013 10.1515/cclm-2014-1013 25389995 · DOI
  18. [22]Lippi G, Bonelli P, Bonfanti L, Cervellin G. The use of S-Monovette is effective to reduce the burden of hemolysis in a large urban emergency department. Biochem Med (Zagreb) 2015;25:69-72. https://doi.org/10.11613/BM.2015.008. PMC4401311 25672469 · DOI
  19. [23]Lippi G Ippolito L Zobbi V Sandei F Favaloro EJ Sample collection and platelet function testing: influence of vacuum or aspiration principle on PFA-100 test results. Blood Coagul Fibrinolysis. 2013; 24: 666– 9. 10.1097/MBC.0b013e32835fada7 10.1097/MBC.0b013e32835fada7 23470650 · DOI
  20. [24]Lippi G Banfi G Church S Cornes M De Carli G Grankvist K Preanalytical quality improvement. In pursuit of harmony, on behalf of European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) Working group for Preanalytical Phase (WG-PRE). Clin Chem Lab Med. 2015; 53: 357– 70. 10.1515/cclm-2014-1051 10.1515/cclm-2014-1051 25490032 · DOI
  21. [25]Juricic G Kopcinovic LM Saracevic A Bakliza A Simundic AM Liquid citrate acidification introduces significant glucose bias and leads to misclassification of patients with diabetes. Clin Chem Lab Med. 2016; 54: 363– 71. 10.1515/cclm-2015-0358 10.1515/cclm-2015-0358 26136303 · DOI
  22. [26]Juricic G Bakliza A Saracevic A Kopcinovic LM Dobrijevic S Drmic S Glucose is stable during prolonged storage in un-centrifuged Greiner tubes with liquid citrate buffer, but not in serum and NaF/KOx tubes. Clin Chem Lab Med. 2016; 54: 411– 8. 10.1515/cclm-2015-0746 10.1515/cclm-2015-0746 26695197 · DOI
  23. [28]Saracevic A Nikolac N Simundic AM The evaluation and comparison of consecutive high speed centrifugation and LipoClear® reagent for lipemia removal. Clin Biochem. 2014; 47: 309– 14. 10.1016/j.clinbiochem.2014.01.001 10.1016/j.clinbiochem.2014.01.001 24434304 · DOI
  24. [29]Nikolac N Simundic AM Miksa M Lima-Oliveira G Salvagno GL Caruso B Heterogeneity of manufacturers’ declarations for lipemia interference – urgent call for standardization. Clin Chim Acta. 2013; 426: 33– 40. 10.1016/j.cca.2013.08.015 10.1016/j.cca.2013.08.015 23981842 · DOI
  25. [30]Culjak M Nikolac N Simundic AM Short term storage stability of serum angiotensin-converting enzyme (ACE) activity. Clin Chim Acta. 2015; 446: 261– 2. 10.1016/j.cca.2015.05.001 10.1016/j.cca.2015.05.001 25957986 · DOI
  26. [31]Nikolac N Celap I Filipi P Hemar M Kocijancic M Miler M Croatian laboratories have a good knowledge of the proper detection and management of hemolyzed, icteric and lipemic samples. Clin Chem Lab Med. 2016; 54: 419– 25. 10.1515/cclm-2015-0650 10.1515/cclm-2015-0650 26426892 · DOI

Cited by

Sorted by citations

See all 18

Metadata

Authors
Nikolac, N., Lenicek Krleza, J., & Simundic, A.-M.
Affiliations
Sisters of Charity Hospital (HR)
ORCID
Nikolac, Nora
Venue
Biochemia Medica
Publisher
Croatian Society for Medical Biochemistry and Laboratory Medicine
Published
2017
Volume
27
Issue
1
Pages
131-143
ISSN
  • 1330-0962 (ISSN-L)
  • 1846-7482
DOI
10.11613/bm.2017.017
PMC
PMC5382847
OpenAlex
W2586198021
Cited by
18
References
0
Citations by year
2025: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2019: 5 · 2018: 4 · 2017: 4
FWCI
2.63
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Biochemia Medica (publishedVersion, cc-by)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • University of Zagreb University Computing Centre (SRCE) (submittedVersion, other-oa)
Topics
  • Health Sciences › Health Professions › Medical Laboratory Technology › Clinical Laboratory Practices and Quality Control
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Quality and Management
  • Health Sciences › Health Professions › Medical Laboratory Technology › Quality and Safety in Healthcare
Keywords
external quality assessment, phlebotomy, laboratory compliance, patient identification, patient preparation, sample storage, glucose measurement
MeSH terms
Biochemistry, Blood Specimen Collection, Humans, Quality Assurance, Health Care, Quality Control, Surveys and Questionnaires, Specimen Handling, Medical Laboratory Science, Croatia, Phlebotomy, Clinical Laboratory Techniques

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

How to cite

Cite CoChat for the checks on this page, and the paper for its own findings.

This page
CoChat. (2026). Citation check: Preanalytical external quality assessment of the Croatian Society of Medical Biochemistry and Laboratory Medicine and CROQALM: finding undetected weak spots. https://app.cochat.ai/papers/10.11613/bm.2017.017
The paper
Nikolac, N., Lenicek Krleza, J., & Simundic, A.-M. (2017). Preanalytical external quality assessment of the Croatian Society of Medical Biochemistry and Laboratory Medicine and CROQALM: finding undetected weak spots. Biochemia Medica. https://doi.org/10.11613/bm.2017.017