Abstract
IntroductionSpecimen adequacy is a crucial preanalytical factor affecting accuracy and usefulness of test result. The aim of this study was to determine the frequency and reasons for rejected haematology specimens, preanalytical variables which may affect specimen quality, and consequences of rejection, and provide suggestions on monitoring quality indicators as to obtain a quality improvement.Materials and methodsA cross-sectional survey was conducted and a questionnaire was sent to 1586 laboratories. Participants were asked to provide general information about institution and practices on specimen management and record rejections and reasons for rejection from 1st to 31st July.ResultsA total survey response rate was 56% (890/1586). Of 10,181,036 tubes received during the data collection period, 11,447 (0.11%) were rejected, and the sigma (σ) was 4.6. The main reason for unacceptable specimens was clotted specimen (57%). Rejected specimens were related to source department, container type, container material type, transportation method and phlebotomy personnel. The recollection of 84% of the rejected specimens was required. The median specimen processing delay in inpatient, outpatient and emergency department were 81.0 minutes, 57.0 minutes and 43.3 minutes, respectively.ConclusionsOverall, rejection rate was a slightly lower than previously published data. In order to achieve a better quality in the preanalytical phase, haematology laboratories in China should pay more attention on training for phlebotomy and sample transportation, identify main reasons for clotted specimen and take effective measures. The platform in the study will be helpful for long-term monitoring, but simplification and modification should be introduced in the following investigation.
Highlights
Specimen adequacy is a crucial preanalytical factor affecting accuracy and usefulness of test result
In order to achieve a better quality in the preanalytical phase, haematology laboratories in China should pay more attention on training for phlebotomy and sample transportation, identify main reasons for clotted specimen and take effective measures
The platform in the study will be helpful for long-term monitoring, but simplification and modification should be introduced in the following investigation
Summary
Specimen adequacy is a crucial preanalytical factor affecting accuracy and usefulness of test result. Laboratory medicine seems overall less vulnerable to mistakes and violations than other clinical and diagnostic areas, the chance of errors is still not negligible and may generate adverse consequences on both the quality of testing and patient safety [1]. For errors in total testing process (TTP), preanalytical errors have been found at the majority of the total errors (46 - 68%) in laboratory medicine, mainly emerging from manually intensive activities, especially those related to collection, handling, transportation, preparation and storage of diagnostic specimens. Specimen adequacy is a crucial preanalytical factor affecting the accuracy and usefulness of test result [3]. Data on rejected samples due to various types of pre-
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