REQUISITION FORMS AND REPORTS-'GARBAGE IN GARBAGE OUT' – SIGNIFICANCE OF CLINICAL DATA IN MICROBIAL CULTURE & ANTIBIOTIC SUSCEPTIBILITY TESTING OF SURGICAL SAMPLES

Abstract

OBJECTIVES: The pre-analytical phase of laboratory testing is an important component of testing process. Laboratory requisition forms(LRF) for microbial culture and antibiotic susceptibility testing for pus, exudate, aspirate, tissue and swabs were analysed in our study following a noncompliance identied during a National Accreditation Board for Testing and Calibration Laboratories(NABL) Surveillance Audit. METHODS: LRFs were analyzed between June-August 2019 for various components in this prospective study. RESULTS: Of the 424 LRFs, 35 % were from outpatients and 65% from in-patients. 100% of the forms had patient identiers of patient name, age, unique hospital identication number. 97.6 % of the LRFs had sample type mentioned. 95.5 % did not mention who collected the sample. 95.7 % did not mention the time of collection. 79.2 % had clinical ndings mentioned but 22.4 % did not mention the site of infection. Only 8 % had history of antibiotics mentioned and 1.4 % had previous culture reports mentioned. 5.6% had no name of the requesting physician mentioned and 3.5 % were illegible abbreviations. 6.1% did not have signature of the requesting doctors, 0.4 % had illegible signatures. 4.2 % had no date on LRFs. CONCLUSION: Our root cause analysis helped us in identifying the factors for incomplete LRFs based on which we recommend proper categorization of samples with test codes on requisition forms, use of information & technology to integrate electronic data entry to reduce transcription errors, periodic training of doctors on pre-analytical phase of testing, stringent sample rejection and acceptance criteria and regular audits of LRFs.