Avaliação do desempenho analítico do setor de bioquímica em um laboratório de análises clínicas de um hospital público de Fortaleza-CE

Abstract

Clinical analysis laboratories are part of the health system with the aim of providing diagnostic and pharmacotherapeutic assistance, so that laboratory reports are responsible for up to 75% of the information necessary for the medical decision. Within the scope of laboratory management, the Internal Quality Control (CIQ) is the basis for monitoring deviations in the system in order to emphasize the commitment of clinical analyzes to the reliability of laboratory reports and the patient safety chain. This work aims to evaluate the analytical performance of the biochemistry sector in a clinical laboratory in the city of Fortaleza, Ceará. The methodology adopted is based on the determination of analytical imprecision from the processing of data referring to 15 biochemical parameters obtained in the first half of 2022. The results were grouped in LeveyJennings type graphs to evaluate deviations in the system from the application of the Westgard's multi-rules system. The knowledge of the system variation determined that all analytes presented satisfactory results with the average value and the variation established by the manufacturer. 12 of the 15 analytes under study were classified as having acceptable performance according to performance criteria based on biological variation. The percentage distribution identified that 33.33% of the parameters presented excellent performance, 33.33% desirable performance, 13.33% minimum performance e 20.01% unsatisfactory performance. The chloride, sodium and magnesium markers showed dispersions above the minimum quality specifications, which suggests the need for priority improvements, especially in the context of water quality applied to biochemical analyzes. Finally, the control charts showed results compatible with the control limits, which is associated with good practices in intralaboratory control.