Causes of rejection of blood samples handled in the clinical laboratory of a University Hospital in Porto Alegre

Targeting Rejection: Analysis of Specimen Acceptability and Rejection, and Framework for Identifying Interventions in a Single Tertiary Healthcare Facility

“…While some previous single‐institution studies of rejection patterns have reported that hemolysis is the predominant cause for specimen rejection , others have found a preponderance of clotted specimens , specimens with insufficient volume , and labeling irregularities . Yet other laboratories have reported a significant number of specimens in three or more of these categories . At JHBMC, clotted and hemolyzed specimens had nearly equal prevalence during the year of this investigation, together comprising 94.6% of rejected specimens.…”

“…Unfortunately, little guidance is available for laboratories that find themselves with an excessive proportion of rejected specimens. Most studies that evaluated this issue in individual laboratories simply cataloged the reasons for rejection, including specimen hemolysis, clotting, mislabeled specimens, and insufficient quantity for test (2,6,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). Additionally, a separate body of literature has reported phlebotomy interventions to ameliorate specific acceptability issues, such as techniques to mitigate hemolysis (19)(20)(21) and incorrect labeling (22,23).…”

The Evaluation of Error Types and Turnaround Time of Preanalytical Phase in Biochemistry and Hematology Laboratories

“…In the current study, insufficient volume (48.8%) was the most common factor leading to specimen rejection in the hematology laboratory and the second common factor in the biochemistry laboratory (45.6%). Similarly, this factor was the second common cause of specimen rejection in several studies (9)(10)(11)(12). Literature shows that the incidence of insufficient volume is remarkably high in pediatric, neonatal, and oncology wards, in which peripheral vascular access is difficult (14,15).…”

“…The reported incidence of the specimens rejected by biochemistry and hematology laboratories ranged 0.3% to 2.7% (8)(9)(10). Similarly, in the current study, the incidence of the specimens rejected by the biochemistry and hematology laboratories were 0.6% and 1%, respectively.…”

“…Similarly, in the current study, the incidence of the specimens rejected by the biochemistry and hematology laboratories were 0.6% and 1%, respectively. Table 3 summarizes comparative data regarding types of preanalytical errors in the previous studies (9)(10)(11)(12)(13).…”