Causes and Counter Measure Analysis of Inpatients Unqualified Clinical Specimens from 2015 to 2019.

BACKGROUND: To improve the quality of pre-analytical phase and provide targeted suggestions, this study analyzed factors causing unqualified clinical specimens in patients of the Department of Clinical Laboratory of Renmin Hospital of WuHan University from 2015 to 2019. METHODS: Inpatient specimens from January 2015 to December 2019 were retrospectively analyzed. Unqualified specimens were identified by referring to the general principle of rejection. The analytical indicators included incidence rate of unqualified specimens and constituent ratio of reasons of unqualified specimens. These two indicators were analyzed according to the inpatient wards and types of specimens. RESULTS: From 2015 to 2019, 21,674 inpatient unqualified specimens were collected, the incidence rate of unqualified specimens was 0.22% (21,674/9,700,869), the number and rate of unqualified specimens decreased year by year. The main reasons of unqualified specimens were insufficient volume (29.67%, 6,430/21,674) and clotting (26.31%, 5,703/21,674). The number of unqualified specimens in the departments of cardiovascular, pediatrics, neurology, oncology, urinary surgery, and intensive care unit ranked the top each year. Clotting (39.29%, 5,682/14,462) was the main reason of unqualified blood specimens while insufficient volume (71.18%, 3,365/4,727) was for urine specimens. Wrong identification caused unqualified feces (62.65%, 728/1,162) and body fluid (40.74%, 539/1,323) specimens. CONCLUSIONS: Clinical laboratory could make effective measures to improve pre-analytical quality by retrospectively analyzing data of unqualified specimens.