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Clinical consequences of specimen rejection: a College of American Pathologists Q-Probes analysis of 78 clinical laboratories.

Abstract：

CONTEXT:Clinical laboratory specimens may be rejected as unsuitable for analysis for a variety of reasons and specimen rejection may have significant clinical consequences. OBJECTIVE:To quantify the clinical consequences of specimen rejection and determine the impact of laboratories' policies and practices on these consequences. DESIGN:Participants prospectively reviewed consecutive blood and urine specimens submitted to the chemistry and/or hematology laboratories to identify rejected specimens. For each rejected specimen, the patient's age, specimen type, testing priority, rejection reason, time from specimen receipt to receipt of recollected/relabeled specimen, recollection method, and test result time were recorded. Specimen/test abandonment was determined by failure to recollect or relabel a rejected specimen. Each laboratory's policy regarding relabeling of incorrectly labeled specimens was recorded, along with how many relabeled specimens were subsequently discovered to be mislabeled. RESULTS:Specimen rejection led to a (1) high rate of specimen recollection, (2) delay in result availability (median of 65 minutes), and (3) high rate of specimen/test abandonment. Longer test result delay was associated with higher hospital bed size; and higher test abandonment rate, with failure of the laboratory to request specimen recollection. Relabeling of incorrectly labeled specimens was found to be of little benefit and was associated with a substantial percentage of subsequently mislabeled specimens. CONCLUSION:Specimen rejection has significant clinical consequences, including patient discomfort, significant delay in result availability, and high rate of specimen/test abandonment. Allowing routine relabeling of incorrectly labeled specimens is a dangerous practice, with little measureable benefit and with an increased risk to patient safety.

journal_name

Arch Pathol Lab Med

journal_title

Archives of pathology & laboratory medicine

authors

Karcher DS,Lehman CM

doi

10.5858/arpa.2013-0331-CP

subject

Has Abstract

pub_date

2014-08-01 00:00:00

pages

1003-8

issue

eissn

0003-9985

issn

1543-2165

journal_volume

138

pub_type

杂志文章

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Clinical consequences of specimen rejection: a College of American Pathologists Q-Probes analysis of 78 clinical laboratories.