RATE AND CAUSES OF INPATIENT BLOOD SAMPLE REJECTION AT PHUC HUNG HOSPITAL

Abstract

Background: Specimen quality and preanalytical errors have a substantial impact on diagnostic accuracy and clinical decision-making. Analysis of specimen rejection rates and underlying causes, particularly among inpatients, provides an essential basis for improving patient care quality. Objectives: To determine the rejection rate of inpatient blood specimens, identify the main causes of rejection, and analyze associated factors. Materials and Methods: A cross-sectional descriptive study was conducted on 30,406 blood specimens collected from inpatient departments at Phuc Hung Hospital between January and June 2025. Causes of specimen rejection were classified according to CLSI GP33A guidelines (hemolysis, clotting, incorrect volume, incorrect patient information, etc.). Results: A total of 104 out of 30,406 specimens were rejected, corresponding to a rejection rate of 0.34%. The Emergency and Intensive Care-Toxicology Department accounted for the highest proportion of rejected specimens (43.18%). The most common causes were hemolysis (25.0%) and incorrect patient information (18.27%). The Pediatrics Department had a six-fold higher risk of specimen rejection compared with the General Internal Medicine Department. Conclusions: Specimen rejection rates were concentrated in Emergency and Intensive Care-Toxicology Department, with hemolysis and administrative information errors as the predominant causes. The highest risk of rejection is in the Pediatrics department. Enhanced training in blood collection and specimen handling for nursing staff is necessary to minimize preanalytical errors and improve overall laboratory testing quality.