Abstract
Intervention by clinical laboratory staff members in the evaluation of non-negligible false values in clinical laboratory tests can lead to appropriate management of patients. Serum/plasma potassium levels can be influenced by pre-analytical processes, and falsely elevated potassium levels can mislead physicians to prescribe unnecessary treatments. A 72-year-old woman with autoimmune hepatitis was hospitalized. In the examinations during hospitalization, her potassium levels varied (3.9–6.2 mmol/L) but her condition was consistent. Her laboratory findings showed no evidence of hemolysis, and there was no marked increase in blood cell counts. To determine the condition of blood collection, we visited her room. Visiting her bedside revealed that her handgrip was excessive before blood collection. Her potassium level after sufficiently opening her hand was 4.0 mmol/L, whereas that after excessive handgrip was 4.9 mmol/L. Thus, her potassium levels could be affected by the excessive handgrip. To share information on blood collection with doctors and nurses, these findings were written in the medical record and she was educated to tell blood-collection operators about the potential elevation of potassium levels when her blood is drawn. After the information sharing and patient education, no elevated potassium levels were observed. The quality control of pre-examination processes requires not only measures by medical staff members but also self-awareness on the part of the patient. Active cooperation and information sharing by clinical laboratory staff members can contribute to achieving high-quality healthcare.
