ABSTRACT
@#Introduction: Error in blood sampling is of one the commonest causes of laboratory sample rejection and poses a great challenge particularly amongst oncology patients due to difficult venous access. This study aims to identify the main causes of blood sample rejection in the haematology and chemical pathology (CP) laboratories of an oncology institute. Method: All blood samples received and rejected in the CP and haematology laboratory from 2017 to 2019 were obtained from the laboratory information system (LIS) and sample rejection logbook. The rejection cause for each of the rejected samples was recorded and analysed. Results: Out of the total 39 495 blood samples received, 244 (0.6%) were rejected. The rejection rate in the CP was higher compared with that in the haematology laboratory (51.2% vs. 48.8%). The most frequent cause of rejection was haemolysis (49.6%), clotted sample (32.8%), and insufficient sample volume (6.1%). Conclusion: Haemolysis, clotted blood and insufficient sample were the main causes of sample rejection in our oncology centre. Effective and multidisciplinary targeted interventions to reduce blood sampling error are important to improve pre-analytical handling of blood samples from oncology patients.
ABSTRACT
In modern diagnostics, it is extremely important to maintain and ensure quality of laboratory results dispatched. It is part of the total quality management and an essential criterion for accreditation of the laboratory. The analysis of biochemistry samples can be broadly divided into three phases: pre-analytical, analytical and post-analytical phase. We wanted to identify the commonly occurring pre-analytical errors and determine the turnaround time in the emergency biochemistry laboratory at a tertiary care hospital in Delhi.METHODSA cross-sectional study was done on a total of 2,73,111 samples received in the emergency biochemistry laboratory from September 2018 to August 2019 and an analysis of occurrence of pre-analytical errors was done, retrospectively. Additionally, the turnaround time of the laboratory was evaluated over a period of two months from July 2019 to August 2019 and average time was recorded. Data was collected from entry registers and rejected samples registers.RESULTSIn this study it was found that 10.58 % of the total samples received were rejected. Moreover, overall turnaround time was found to be 108 minutes (median value). In the present study, haemolysis was the most common reason for sample rejection. (63.14% of total rejections). Additionally, the second most common error was inadequate samples. 6570 samples were rejected due to this reason (22.73%).CONCLUSIONSHaemolysis was the most common cause of rejection in the emergency biochemistry laboratory. Also, it was seen that the most time-consuming step was analysis in auto-analyser with respect to contribution to turnaround time. As a matter of fact, Pre-analytical errors can adversely affect the treatment of patients. However, most of the errors can be reduced by proper training of the staff and checking competency thoroughly by conduction of practical and theory assessment of laboratory personnel at frequent intervals
ABSTRACT
Background: Quality in the health care institutions is multifaceted & multidimensional with its core element as the customer’s satisfaction. Improvement in the health care services is a long drawn relentless process which can be achieved by implementing a carefully planned Quality Management System. Laboratory services B.J. Medical College & Civil Hospital Ahmedabad, has set its Quality indicators and is monitoring it as a part of continual improvement. One of the Quality indicators is Sample rejection. The laboratory aims to reduce the sample rejections by complying with the standards & recommended guidelines. Methods: This is to monitor & analyze the Sample Rejections as a Quality Indicator for Continual improvement of the Microbiology Department. Primary data collection done before training & secondary data collection done after the training of nursing staff & Resident Doctors. Results: The sample rejection rate of the Microbiology Laboratory in the month of July 2010 was 0.31%. After the training of the nursing staff as well as resident doctors regarding proper collection & transport of samples based on scientific principles, a decreasing trend in the sample rejection rate is observed. i. e. from .31% to 0.11 % in the 13 months duration of study.Conclusion: The implementation of a systematic error-tracking system i.e. monitoring the sample rejections, analysing its trend, taking preventive & corrective actions to reduce the sample rejection rate in daily practice definitely improves the quality of the laboratory results and is a quality indicator for continual improvement of the laboratory.