Pre-analytical compliance assessment in anatomopathology: implications for surgical care safety in two hospitals in Cameroon

Abstract

Background: In surgery, anatomic pathology examination conditions major therapeutic decisions. The pre-analytical phase generates 85% of errors likely to impact patient safety. This study aimed to evaluate the impact of pre-analytical non-conformities in histological samples on the quality of surgical care, with comparative analysis across surgical specialities.

Methods: Descriptive cross-sectional study conducted from April to June 2023 in two Yaoundé hospitals. Exhaustive sampling of 276 consecutive histological samples evaluated according to a standardized checklist based on AFAQAP and ISO 15189 recommendations. Analyzed criteria included complete patient and prescriber identification, temporal traceability, histological fixation conditions, and biological safety documentation. Descriptive analyses with 95% confidence intervals and comparisons using Chi-square test (p<0.05).

Results: Overall compliance rate was 65.2%. Critical non-conformities concerned collection time (91% non-compliance), fixative concentration, and infectious status (100% non-compliance). Complete patient identification was achieved in only 83.3% of cases. Comparative analysis revealed no significant differences among surgical specialties (p>0.05), confirming the systemic nature of observed failures.

Conclusion: Pre-analytical failures expose all surgical patients to major diagnostic risks compromising therapeutic safety. The systemic and cross-specialty nature of these failures requires a comprehensive approach integrating documentary standardization and continuing education.