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2017, Cilt 15, Sayı 3, Sayfa(lar) 119-128
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Sample Rejection in Outpatient, Inpatient and Emergency Bloods: Traning and New Approaches
Yeşim Güvenç
Celal Bayar Üniversitesi Tıp Fakültesi, Tıbbi Biyokimya, Manisa, Türkiye
Keywords: sample rejection; preanalytical phase; insufficient volume; hemolysis

Purpose: Rejection of unsuitable samples is important for the quality of the laboratory results. In our study, it is aimed to perform sample rejection analysis of blood samples from outpatient, inpatient and emergency units and to evaluate the effectiveness of the training in reducing sample rejection rates and to determine new measures to be taken.

Materials and Methods: Rejected blood samples data receive from laboratory information system between January 1 and October 31, 2016 were evaluated retrospectively. The samples were evaluated according to the reject reasons, the unit from which blood is taken and the type of samples. At the end of the May nurses were trained.

Results: Total sample rejection rate is 1.30%. Total, outpatient and inpatient samples rejection rates were found statistically significantly lower after training than before training (p=0.009, p=0.001, p=0.001, respectively). Samples were rejected due to 40.26% insufficient volume, 30% clotted, 12.99% hemolyzed, 4.88% false request, 4.23% false sample and 7.63% due to other reasons. Inpatient (45.95%) and outpatient (52.75%) samples were most frequently rejected because of insufficient volume. Emergency samples were most frequently rejected because of clotted samples (41.7%).

Conclusion: The most common cause of sample rejection is insufficient volume.Training reduced sample rejection rates in total, inpatient and outpatient blood. Standardized practical trainings should apply in small groups to the all staff periodically. In order to reduce our sample rejection rates further, it is recommended to establish professional phlebotomy teams and to determine our preferred preanalytical phase quality indicators and to participation in a preanalytical external quality assurance program.


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