Introduction: Clinical diagnosis is mostly dependent on laboratory test results. Studies have shown that 70% of clinical laboratory samples are rejected due to pre-analytical errors. This study was conducted to assess; rejection rates of blood samples, major reasons for rejection of blood samples, and knowledge, attitudes and practice of nurses on blood sample collection. Methods: Details of rejected blood samples were collected using data sheets of rejected blood specimens at the Teaching Hospital Karapitiya, Sri Lanka. Knowledge, attitudes and practices of nursing officers on blood sample collection were assessed using a self-administered questionnaire. Data were analyzed using SPSS version 22. Results: Overall blood sample rejection rate was 3.3%. The major cause of rejection of blood samples was the clotting of specimens. Insufficient volume, hemolysis, unavailability of request form for investigation, discrepancies in bed head tickets, discrepancies of the names, and use of IV line for blood collection were among the other reasons for sample rejection. The highest rejection rate was reported from the samples obtained for Prothrombin time/International Normalized Ratio (PT/INR) test. According to the scores obtained for knowledge of the nurses on blood sample collection, 43% of them scored ‘average’ while 38% scored ‘good’. The nurses’ attitudes on blood sample collection were satisfactory. Conclusions: Overall rejection rate was higher in the Haematology Laboratory of Teaching Hospital Karapitiya compared to the values reported elsewhere. Although the overall knowledge of nurses was satisfactory regarding blood sample collection, aspects such as knowledge on the correct volume of blood needed for specific investigations, choosing a suitable site for blood drawing, and practices such as the provision of duly filled investigation forms need to be improved.Keywords: Rejection rate, Pre-analytical error, Haematology, Blood, Sample collection

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Clinical trials are defined as studies involving human participants, with the intervention being selected by the investigator (1). The intervention can be related to a new drug or device, or a new indication for an already approved drug or device. The intervention can also relate to different healthcare options, eg the trial may be aimed at comparing the management of a particular illness in the hospital to its management in the community.The state regulatory body for drugs in Sri Lanka is the Cosmetics Drugs and Devices Regulatory Authority (CDDRA). The CDDRA's permission is required for the registration and import of new drugs. In January 2009, the ministry of health appointed a subcommittee on clinical trials (SCOCT) under the CDDRA. The SCOCT's regulatory approval is necessary for clinical trials. The SCOCT requires ethical approval by a recognised ethics review committee (ERC). Further, according to the regulations, registration in the primary World Health Organization clinical trial registry network is mandatory. The clinical trial registry, which is in the premises of the Sri Lanka Medical Association, is the only such registry in the country.Recently, bureaucrats in the health and the finance ministries, as well as a few academics, have been pushing for a new Act on clinical trials (2). This paper highlights the various loopholes in this draft Act and describes how it may give the pharmaceutical companies opportunities to circumvent its provisions and exploit patients. The clinical trial industry has been perceived by these Faustian treasury economists as a magnet for foreign currency. The draft Act reflects an insouciant attitude to the patient's welfare and the free health system, which is unique to Sri Lanka. There were no consultations with the public or the stakeholders when this Act was drafted, and its provisions have still not been made known to academics, ERCs and the public.

Critical results require immediate medical intervention. The study aimed to determine knowledge, attitudes and practices on critical results management among Medical Laboratory Technologists (MLTs) in southern province, Sri Lanka. A descriptive cross-sectional study was conducted using a selfadministered, pre-tested questionnaire with the participation of 85 MLTs. The results were analysed using SPSS software version 21. 32.9% of the participants stated that there is a critical result management system in the laboratory and 42.4% stated that there is no critical result management system in the laboratory. Among the participants, 23.5% were not aware whether there is a critical result management system in their laboratory. Study participants were categorized based on their knowledge and practice scores. The mean (SD) knowledge score and practice score of the participants were 42.20(±11.67) and 43.39(±10.66). MLTs exceeding ten years of experience had a significantly higher knowledge score (50.38±10.51) compared to MLTs with less than ten years of experience (40.67±11.07, p=0.008). The MLTs with more than 30 years of experience had a significantly higher practice score (58.25±3.95) compared to MLTs with less than one year of experience (39.30±7.57, p=0.002). There was no statistically significant difference in knowledge score and practice score between MLTs with reference to gender, age or education. The overall knowledge and practice of MLTs on critical results management is not satisfactory. The overall attitudes of MLTs on critical results management are satisfactory. The study emphasizes the value of conducting educational and training programs on critical results management and the evaluation of their effectiveness.

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