Analysis of laboratory sample rejections in the pre-analytical stage at an oncology center

Bhat, Vivek; Tiwari, Manikchandra; Chavan, Preeti; Kelkar, Rohini

doi:10.1016/j.cca.2012.03.024

Cited by 22 publications

(18 citation statements)

References 16 publications

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“…At the end, however, most of the rejected specimens, even those that were repeatedly rejections in certain patients, were closely linked to one or more of the following three factors: specimen clotting or hemolysis, location in emergency or ICU locations, and collection by nonlaboratory phlebotomy staff. Both clotting and hemolysis were previously in other studies described to be strongly linked to poor phlebotomy technique . Moreover, studies described that continuing education in proper phlebotomy techniques for nurses in critical care locations is almost nonexistent .…”

Section: Discussionmentioning

confidence: 97%

“…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).…”

Section: Introductionmentioning

confidence: 99%

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

Rooper

Carter

Hargrove

et al. 2016

Clinical Laboratory Analysis

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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

Rooper

Carter

Hargrove

et al. 2016

Clinical Laboratory Analysis

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“…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).…”

Section: Discussionmentioning

confidence: 99%

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

Çakırca

2018

Iran J Pathol

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Background & objective:Each laboratory should determine the type of errors and turnaround time (TAT), especially in the preanalytical phase to report quality and timeliness of the test results. The current study aimed at investigating the common causes of preanalytical errors in biochemistry and hematology laboratories and evaluating the preanalytical TAT for outpatient samples. Methods: Data of rejected samples in the laboratory information system from September 2014 to September 2015 were retrospectively reviewed. Also, the preanalytical TAT of the outpatient samples was evaluated over the period of three months from June to August 2015. Preanalytical TAT was calculated from order entry to barcode scanning in the autoanalyzer. Results: With respect to the ratios of blood sample transfers, 1% of samples (2305 out of 225,563) in the hematology laboratory and 0.6% (1467 out of 255,943) in the biochemistry laboratory were rejected. The most common cause of rejection in the hematology and biochemistry laboratories was insufficient volume (48.8%) and hemolyzed sample (74.1%), respectively. The average preanalytical TAT for the outpatient samples was 62.3 minutes.The preanalytical TAT accounted for 10.8% (order entry-sample collection), 49% (sample collection-sample receipt), and 40.2% (sample receipt-barcode scanning in the autoanalyzer), respectively. Conclusion:Of all the samples received in the biochemistry and hematology laboratories, the overall percentage of rejections were 0.6% and 1%, respectively. The main target to improve preanalytical TAT was determined as the transportation (sample collection-sample receipt) step.

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“…For example the risk of these events is higher in the emergency departments due to rapid patient turnover, more interruptions to the medical staff in ED, 32 patients arrive unexpectedly who maybe unconscious or with no identification when compared to in patient setting where the patients are admitted for days for their treatment. 33 The findings from this review may not be generalizable across different type of healthcare settings due to limited data availability to investigate whether the recommended practices are equally effective in all types of settings (e.g., ED, pediatrics).…”

Section: Study Limitations and Future Research Needsmentioning

confidence: 97%

“…13, 19, 31 Other factors contributing to labeling errors are identified as lack of compliance by the staff to the specimen labeling SOPs majority of the times due to the short cuts and workarounds 32 , furthermore staff turnover is a major issue in lab and nursing. 33 To mitigate these barriers incorporating staff training sessions into their orientation as well as routine continuing ongoing professional development sessions may prove to be more effective vs. one time training. Annual competency checks for new as well as existing employee(s) is required.…”

Section: Considerations For Implementationmentioning

confidence: 99%

Effectiveness of Laboratory Practices to Reduce Specimen Labeling Errors at the Time of Specimen Collection in Healthcare Settings: A Laboratory Medicine Best Practices (LMBP) Systematic Review

Sandhu

Bandyopadhyay

Hunt

et al. 2017

The Journal of Applied Laboratory Medicine

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Background Specimen labeling errors have long plagued the laboratory industry putting patients at risk of transfusion-related death, medication errors, misdiagnosis, and patient mismanagement. Many interventions have been implemented and deemed to be effective in reducing sample error rates. The objective of this review was to identify and evaluate the effectiveness of laboratory practices/ interventions to develop evidence based recommendations for the best laboratory practices to reduce labeling errors. Content The standardized LMBP™ A-6 methods were used to conduct this systematic review. Total evidence included 12 studies published during the time periods of 1980 to September 2015. Combined data from seven studies found that the interventions developed as a result of improved communication and collaboration between the laboratory and clinical staff resulted in substantial decrease in specimen labeling errors (Median relative percent change in labeling errors: −75.86; IQI: −84.77, −58.00). Further data from subset of four studies showed a significant decrease in specimen labeling errors after the institution of the standardized specimen labeling protocols (Median relative percent decrease in specimen labeling errors: −72.45; IQI: −83.25, −46.50). Summary Based on the evidence included in this review, the interventions that enhance the communication and collaboration between laboratory and healthcare professionals can decrease the specimen identification errors in healthcare settings. However, more research is needed to make the conclusion on the effectiveness of other evaluated practices in this review including training and education of the specimen collection staff, audit and feedback of labeling errors, and implementation of new technology (other than barcoding).

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Analysis of laboratory sample rejections in the pre-analytical stage at an oncology center

Cited by 22 publications

References 16 publications

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

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

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

Effectiveness of Laboratory Practices to Reduce Specimen Labeling Errors at the Time of Specimen Collection in Healthcare Settings: A Laboratory Medicine Best Practices (LMBP) Systematic Review

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