Determination of the Rate and Reasons of Blood Sample Rejection in the Pre-Analytical Phase in Ruhengeri, Rwanda: A Single Center Study

All three phases of laboratory testing are equally important for improving total quality management, but the pre-analytical phase is the most error-prone. This study aimed to determine the rate and reasons for blood sample rejection in the pre-analytical phase of laboratory testing in a referral hospital in Ruhengeri, Rwanda.

This study was a cross-sectional and retrospective study in which 222 samples with nonconformities were discovered from 19,775 clinical samples. Various data related to the rejected samples were recorded along with nonconformities.  

The rate of blood sample rejection was 1.045% and 1.165% for the cross-sectional and retrospective approaches, respectively. The overall blood sample rejection rate was 1.105%. The most frequent error in the cross-sectional aspect was mislabeling (38.3%), while clotting (46.4%) was the most common cause of sample rejection in the retrospective aspect.

Based on the results of our study, the rate of blood sample rejection is high in the study area. Thus, there should be a laboratory policy for error record keeping as well as a settlement in “laboratory sentinel events” covering the total testing process.