A national survey of specimen contamination in the UK

Abstract

Specimen contamination that goes unnoticed can have many adverse consequences for patients including inappropriate investigations or treatment decisions based on erroneous results. Little is known about UK laboratory practices relating to specimen contamination; therefore, this national survey aimed to gather valuable baseline data. An electronic survey consisting of 26 questions was designed to obtain key information relating to specimen contamination including its frequency, how it is identified by laboratories and actions taken in event of confirmed contamination. The survey was circulated to Heads of Departments of all NHS laboratories in the UK. Fifty-two responses (15%) were received from 353 laboratories surveyed. Recording and extracting specimen contamination data from laboratory IT systems appear to be a challenge for many laboratories. There is potentially a lack of awareness of correct order of draw for venous blood collection which is a factor known to contribute to contamination. There is wide variation in contamination rates (EDTA, citrate and drip arm), and the methods laboratories use to identify it which often rely on professional judgement. Similarly, there is little consensus among senior laboratory professionals on how best to report results on contaminated samples, and record events in risk management systems. There is a need for greater consensus on laboratories' approach to specimen contamination, particularly around mechanisms to identify and monitor it, and follow up actions. We make several recommendations to facilitate improvements it this area; however, there is a need to develop consensus guidelines which can aid both clinicians and laboratories.