Chemistry and haematology sample rejection and clinical impact in a tertiary laboratory in Cape Town

dc.contributor.authorJacobsz L.A.
dc.contributor.authorZemlin A.E.
dc.contributor.authorRoos M.J.
dc.contributor.authorErasmus R.T.
dc.date.accessioned2012-04-12T08:19:25Z
dc.date.available2012-04-12T08:19:25Z
dc.date.issued2011
dc.description.abstractBackground: Recent publications report that up to 70 % of total laboratory errors occur in the pre-analytical phase. Identifi cation of specifi c problems highlights pre-analytic processes susceptible to errors. The rejection of unsuitable samples can lead to delayed turnaround time and affect patient care. Methods: A retrospective audit was conducted investigating the rejection rate of routine blood specimens received at chemistry and haematology laboratories over a 2-week period. The reasons for rejection and potential clinical impact of these rejections were investigated. Thirty patient fi les were randomly selected and examined to assess the impact of these rejections on clinical care. Results: A total of 32,910 specimens were received during the study period, of which 481 were rejected, giving a rejection rate of 1.46 % The main reasons for rejection were inappropriate clotting (30 % ) and inadequate sample volume (22 % ). Only 51.7 % of rejected samples were repeated and the average time for a repeat sample to reach the laboratory was about 5 days (121 h). Of the repeated samples, 5.1 % had results within critical values. Examination of patient folders showed that in 40 % of cases the rejection of samples had an impact on patient care. Conclusions: The evaluation of pre-analytical processes in the laboratory, with regard to sample rejection, allowed one to identify problem areas where improvement is necessary. Rejected samples due to factors out of the laboratory's control had a defi nite impact on patient care and can thus affect customer satisfaction. Clinicians should be aware of these factors to prevent such rejections. © 2011 by Walter de Gruyter.
dc.identifier.citationClinical Chemistry and Laboratory Medicine
dc.identifier.citation49
dc.identifier.citation12
dc.identifier.citation2047
dc.identifier.citation2050
dc.identifier.issn14346621
dc.identifier.other10.1515/CCLM.2011.743
dc.identifier.urihttp://hdl.handle.net/10019.1/20532
dc.subjectAudit
dc.subjectPatient care
dc.subjectPre-analytical errors
dc.subjectRejection rate
dc.subjectTurnaround time
dc.titleChemistry and haematology sample rejection and clinical impact in a tertiary laboratory in Cape Town
dc.typeArticle
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