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Sample Rejection Rate, Reasons for Rejection and Associated Factors Among Clinical Specimens Requested for Diagnostic
Mahider Shimelis Feyisa1, Ayenew Berhan2, Mekides Andargie Ferede2
1School of Medical Laboratory Sciences, Asrat Weldeyes Health Science Campus Debre Berhan University Debre Berhan Ethiopia.
Background And Aims:
Clinical specimen rejection is a significant issue in laboratory medicine, particularly in resource-limited settings such as Ethiopia. Understanding the underlying reasons for specimen rejection is crucial for implementing effective strategies to minimize errors, enhance laboratory performance, and improve patient care. The aim of this study was to assess the rate and reasons for clinical specimen rejection at Debre Tabor Comprehensive Specialized Hospital Laboratory from June 17 to July 16, 2025.
Methods:
An institution based cross-sectional study was conducted from June 17 to July 16, 2025. It included all specimens submitted for diagnostic testing during the study period. Data were analyzed using STATA version 17. Descriptive statistics were used to assess the rejection rate and identify possible reasons. Binary and Multivariable logistic regression was used to show the association between the rejection rate and independent variables and p-value < 0.05 was considered as statistically significant.
Results:
Out of 952 specimens analyzed, 58; 6.09% (95% CI: 4.6-7.6) were rejected. Mislabeled samples (17; 29.3%) and clotted samples (15; 25.86%) were the common causes of specimen rejection. Most rejections were associated with specimens collected by non-laboratory health professionals 35 (60.3%), not trained refresher training 44 (75.9%), and those with over 6 years of experience 40 (69%). The highest rejection rates were observed from the inpatient service and during the day shift, 51 (87.94%) and 45 (77.58%), respectively. Samples not collected by laboratory personnel and health professionals not taken refresher training had higher odds of rejection.
Conclusion:
The present study showed that the overall specimen rejection rate was relatively high from previous studies conducted. Mislabeled samples, clotted specimens, and low sample volume were the most common reasons of rejection. Samples taken by health professionals not taking refresher training and collected by health professionals other than laboratory personnel showed high risk to be rejected.
