Abstract:

Objective　To analyze the cause and countermeasure of the rejection of blood specimens，and to find solutions to decrease the number of rejected blood specimens for laboratory quality improvement. Methods　A total of 5 933 rejected blood specimens were analyzed retrospectively from 2008 to 2012 in Department of Clinical Laboratory，Zhongshan Hospital，Fudan University. Results were shown by the frequency of rejected blood specimens in which Pearson χ² test was used to evaluate the percentages of clotted specimens and insufficient specimens with different types of tubes. Results　The frequencies of rejected blood specimens from 2008 to 2012 were 1.49 ‰，0.76 ‰，0.52 ‰，0.50‰ and 0.47‰，respectively，with decreasing tendency. The 6 major causes of rejection were clotted blood specimen，insufficient blood volume，inappropriate anticoagulant，error in sample identification，specimen transfer overtime and repeated blood collection. Clotted blood specimen and insufficient blood volume were common in sodium citrate anticoagulant tube specimens compared with others. Conclusions　Clinical laboratories should strengthen the ties with the nurses and clinical doctors whom would be informed with the rejection of blood samples in time，in order to figure out and carry out the solutions，reduce the number of rejected blood specimens and improve the pre-analytical quality.

Key words: Rejected blood specimen, Clinical Laboratory, Pre-analytical stage, Blood specimen quality