Abstract:

Background: Focusing aspects of testing only merely ensure the quality of a clinical laboratory, attention to both TTP phase of testing cycle; pre-analytical and post analytical aspects should be considered so as to improve the overall laboratory diagnosis. This study aims at studying the rejection criteria of the pre analytical phase of laboratory testing. However the issue of sample rejection would have been eliminated if only all procedures involved in first step sample collection to the final step of giving out results were well adhered. In contrary, the issue had received high level of attention due to increasing number of mistakes during the sample collection. Among the facts that makes the study more valuable includes time wasting for the patients, delay of the laboratory results, wastage of laboratory resources, sometime doubles the cost to the patient, some samples are hard to get and delayed treatment to most patients and sometimes the patients may encounter death. Referring to the above mentioned facts, most of them have direct negative consequences to the patients and therefore, in this study we will focus on identifying the causes and pattern of pre-analytical laboratory errors.

Objective: To determine the prevalence, patterns and causes of sample rejections in pre-analytical phase for routine tests in Central Pathology laboratory at Bugando medical centre.

Methods: The study was a descriptive cross sectional study conducted from May, 2019 to June, 2019 where by the principal investigation kept records of all submitted samples to the laboratory. The samples were cross checked for acceptance and rejection whereby causes and patterns of rejection were also documented.

Results: Of all the 1200 samples received and cross-checked, only 3.9% (47/1200) had errors related to pre-analytical phase of testing cycle. Unlabeled samples (1.7%), samples in wrong containers (1.5%), clotted samples (0.6%) and hemolyzed samples (0.2%) amounted to the major proportion of errors.

Conclusion: There is a need to understand the importance of pre-analytical phase with special emphasis on the sample collection related related errors. As with more stringent steps in analytical phase, the pre-analytical phase should equally be given the due importance. Documentation and analysis of the documented laboratory errors as well as taking corrective actions to avoid such errors in future would go a long way to eliminate sample rejection and thereby provide reliable test results within a shortest possible time.