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Analysis of laboratory sample rejections in the pre-analytical stage at an oncology center
Vivek Bhat1, Manikchandra Tiwari, Preeti Chavan
1Advanced Center for Treatment Research and Education in Cancer, Tata Hospital, Kharghar, Navi Mumbai, India. vivekbhat2005@yahoo.com
Background:
Effective patient management depends on the accuracy of laboratory results. Sample collection errors constitute an important reason for repeat collections. This study was conducted at the laboratory diagnostic services of a tertiary care oncology center with a hematopoietic stem cell transplant unit to determine the common causes of sample rejections and see the effects of corrective action.
Methods:
A retrospective, intervention and prospective analysis of the samples rejected from the total samples received in our laboratories, during a nine month period from January to September 2011 was undertaken. Causes of sample rejections were determined and intervention in the form of training relevant staff was instituted.
Results:
Out of 32,548 samples received during Jan-Sep 2011, 177 samples (0.54%) were rejected. The most common reasons for rejection in hematology and biochemistry areas were clotted blood specimen (51.2%), improperly labeled specimen containers (14.46%) and hemolyzed blood samples (11.45%). For microbiology these included labeling errors, collection of specimen in wrong containers and specimen collection date and time not being entered, unacceptable specimen source and delayed transit time (18.2% each).
Conclusions:
Directed interventions may help reduce the incidence of sample rejections.
