Specimen Rejection in the Laboratory of a Secondary Medical Center in Egypt

Abstract Background Errors in Laboratory testing have a direct impact on patient safety, as it directly affects diagnosis and management. Most errors occur in the pre-analytical phase, which occurs outside the laboratory. This study aimed to investigate the laboratory specimen rejection rate and causes in the pre-analytical phase in the laboratory of petroleum medical center. Methods The present study was conducted at Petroleum medical center in Egypt from August 2022 to June 2023. The study included 1701 specimens, Checklist was used to collect data about specimens received at laboratory, it includes information about source of specimen, type of specimen, date and time specimen was collected and received at the laboratory, phlebotomist, specimen transports and storage conditions, whether a specimen was rejected, and the rejection reason. Results Out of 1701 specimens, 98 (5.76%) were rejected. Clotting of anticoagulated specimens caused 49 (50%) of the rejections, followed by insufficient volume and hemolysis accounting for 8 (8.1%) each. Most of the rejected specimens came from the Emergency department 16 (16.33%), intensive care unit 24 (24.94%) and medical ward “6” 27 (27.55%). About 12/69(17.39%) of the specimens collected by physicians were rejected compared to 65/1013 (6.42%) for nurses and 21/619 (3.39%) for laboratory technicians. Conclusions The specimen rejection rate in this study was around 98/1701(5.76%). Clotting of anticoagulated specimens was the most important cause for rejection.