The rate of sample rejection and pre-analytical errors at KCMC Clinical Laboratory in Moshi, Kilimanjaro

Abstract

Background: Over the years, modern medicine has provided better quality services to patients. However, medical error is still prevalent and has a lot of negative consequences on patients’ outcomes. These may include delayed treatment, longer hospital stays, or even worsening of the patient’s condition. This study aimed to determine the sample rejection rate at KCMC Clinical Laboratory and characterize pre-analytical errors that contribute to it.

Methods: Data extraction sheet was used to collect information from rejection forms from January to December 2016. The data collection form gathered information on where samples were collected and send for laboratory analysis, and the types of rejected sample. Information on the reasons for sample rejection were also collected.

Results: The proportion of rejected samples stand at 0.19% (out of 117181 samples received from January to December 2016, 234 were rejected). The highest rates of rejection were from haematology section 78 (33.3%). The major type of rejected sample was blood (86.3%) and 20% of the rejected samples came from internal medicine department, mainly from its inpatient department (13.6%). The commonest reason for rejection was unpaid specimens 84 (35.9%).

Conclusion: Study results indicate the need for improving quality control system which will enhance sample management and prompt identification of deficiencies. The high rate of sample rejection due to lack of payment signify the need for improved government policies that address health expenses coverage. Provision of trainings on phlebotomy and blood samples transportation can reduce the rate of sample rejection due to clotting.