Analysis of rejected specimens in the department of clinical laboratory medicine from 2007 to 2010

Objective To investigate how to control and decrease the number of rejected specimens in order to improve pre-analytical quality. Methods The 40 035 rejected blood specimens from 2007 to 2010 and the rejected body fluid specimens including 162 urine specimens and 167 feces specimens in 2010 in the Department of Clinical Laboratory Medicine, Zhongshan Hospital, Fudan University were analyzed retrospectively.Results were shown by the percentage of rejected specimens in which Pearson χ2 test was used to assess the percentage of clotted specimens with different anticoagulant tubes. Results The percentage of rejected specimens collected by syringes with glass tubes or plastic tubes with anticoagulant artificially was 11.58%, which was higher than that of rejected specimens collected by vacuum blood collection system (1.33%).The percentage of rejected specimens from 2007 to 2010 collected by vacuum blood collection system was 13.29‰, 1.49‰, 0.76‰ and 0.52‰, respectively, which was decreased year by year.The three main reasons of rejected specimens were specimen clotted，insufficient specimen quantity and improper specimen type, respectively.Specimen clotted was more frequently in sodium citrate anticoagulant tube samples than others (χ2=202.3，P=0.000).The rejected specimens of body fluid specimens were mainly feces specimens without samples.The number of rejected feces specimens was significantly decreased from 2‰ above to 1.5‰ below with the implementations of transparent sample containers. Conclusion Appropriate improvement measures of rejected specimens with clinical communication should be taken by the clinical laboratory to reduce the number of rejected specimens and improve pre-analytical quality.（Chin J Lab Med,2012,35:305-308） Key words: Specimen handling; Laboratories，hospital; Organization and administration; Quality control