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Specimen rejection in laboratory medicine: Necessary for patient safety?

INTRODUCTION: The emergency laboratory in Hacettepe University Hospitals receives specimens from emergency departments (EDs), inpatient services and intensive care units (ICUs). The samples are accepted according to the rejection criteria of the laboratory. In this study, we aimed to evaluate the sa...

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Autores principales: Dikmen, Zeliha Gunnur, Pinar, Asli, Akbiyik, Filiz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Croatian Society of Medical Biochemistry and Laboratory Medicine 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4622196/
https://www.ncbi.nlm.nih.gov/pubmed/26527231
http://dx.doi.org/10.11613/BM.2015.037
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author Dikmen, Zeliha Gunnur
Pinar, Asli
Akbiyik, Filiz
author_facet Dikmen, Zeliha Gunnur
Pinar, Asli
Akbiyik, Filiz
author_sort Dikmen, Zeliha Gunnur
collection PubMed
description INTRODUCTION: The emergency laboratory in Hacettepe University Hospitals receives specimens from emergency departments (EDs), inpatient services and intensive care units (ICUs). The samples are accepted according to the rejection criteria of the laboratory. In this study, we aimed to evaluate the sample rejection ratios according to the types of pre-preanalytical errors and collection areas. MATERIALS AND METHODS: The samples sent to the emergency laboratory were recorded during 12 months between January to December, 2013 in which 453,171 samples were received and 27,067 specimens were rejected. RESULTS: Rejection ratios was 2.5% for biochemistry tests, 3.2% for complete blood count (CBC), 9.8% for blood gases, 9.2% for urine analysis, 13.3% for coagulation tests, 12.8% for therapeutic drug monitoring, 3.5% for cardiac markers and 12% for hormone tests. The most frequent rejection reasons were fibrin clots (28%) and inadequate volume (9%) for biochemical tests. Clotted samples (35%) and inadequate volume (13%) were the major causes for coagulation tests, blood gas analyses and CBC. The ratio of rejected specimens was higher in the EDs (40%) compared to ICUs (30%) and inpatient services (28%). The highest rejection ratio was observed in neurology ICU (14%) among the ICUs and internal medicine inpatient service (10%) within inpatient clinics. CONCLUSIONS: We detected an overall specimen rejection rate of 6% in emergency laboratory. By documentation of rejected samples and periodic training of healthcare personnel, we expect to decrease sample rejection ratios below 2%, improve total quality management of the emergency laboratory and promote patient safety.
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spelling pubmed-46221962015-10-30 Specimen rejection in laboratory medicine: Necessary for patient safety? Dikmen, Zeliha Gunnur Pinar, Asli Akbiyik, Filiz Biochem Med (Zagreb) Research Article INTRODUCTION: The emergency laboratory in Hacettepe University Hospitals receives specimens from emergency departments (EDs), inpatient services and intensive care units (ICUs). The samples are accepted according to the rejection criteria of the laboratory. In this study, we aimed to evaluate the sample rejection ratios according to the types of pre-preanalytical errors and collection areas. MATERIALS AND METHODS: The samples sent to the emergency laboratory were recorded during 12 months between January to December, 2013 in which 453,171 samples were received and 27,067 specimens were rejected. RESULTS: Rejection ratios was 2.5% for biochemistry tests, 3.2% for complete blood count (CBC), 9.8% for blood gases, 9.2% for urine analysis, 13.3% for coagulation tests, 12.8% for therapeutic drug monitoring, 3.5% for cardiac markers and 12% for hormone tests. The most frequent rejection reasons were fibrin clots (28%) and inadequate volume (9%) for biochemical tests. Clotted samples (35%) and inadequate volume (13%) were the major causes for coagulation tests, blood gas analyses and CBC. The ratio of rejected specimens was higher in the EDs (40%) compared to ICUs (30%) and inpatient services (28%). The highest rejection ratio was observed in neurology ICU (14%) among the ICUs and internal medicine inpatient service (10%) within inpatient clinics. CONCLUSIONS: We detected an overall specimen rejection rate of 6% in emergency laboratory. By documentation of rejected samples and periodic training of healthcare personnel, we expect to decrease sample rejection ratios below 2%, improve total quality management of the emergency laboratory and promote patient safety. Croatian Society of Medical Biochemistry and Laboratory Medicine 2015-10-15 /pmc/articles/PMC4622196/ /pubmed/26527231 http://dx.doi.org/10.11613/BM.2015.037 Text en
spellingShingle Research Article
Dikmen, Zeliha Gunnur
Pinar, Asli
Akbiyik, Filiz
Specimen rejection in laboratory medicine: Necessary for patient safety?
title Specimen rejection in laboratory medicine: Necessary for patient safety?
title_full Specimen rejection in laboratory medicine: Necessary for patient safety?
title_fullStr Specimen rejection in laboratory medicine: Necessary for patient safety?
title_full_unstemmed Specimen rejection in laboratory medicine: Necessary for patient safety?
title_short Specimen rejection in laboratory medicine: Necessary for patient safety?
title_sort specimen rejection in laboratory medicine: necessary for patient safety?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4622196/
https://www.ncbi.nlm.nih.gov/pubmed/26527231
http://dx.doi.org/10.11613/BM.2015.037
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