SPECIMEN REJECTION CRITERIA
 

Time-Dependent Specimens

Some specimens are time-dependent. In order for the laboratory departments to process them correctly, specimens must be collected/received within their time constraints to be accepted by the Laboratory. The Laboratory Manual should be consulted for specimen time limitations.

Specimen Containers

Specimens must be received in the proper container to be accepted by the Laboratory. For more information, refer to Specimen Containers and Specimen Collection Information.

Rejection of Specimens

Causes for Rejection. Criteria for specimen rejection are dependent on individual tests. Generally, specimens received by the laboratory are not discarded until the physician ordering the test or responsible nursing unit is notified. Events which may lead to the rejection of a specimen include specimen improperly labeled or unlabeled, specimen improperly collected (or suspected of IV contamination) and/or preserved, hemolysis, lipemia, specimen sample volume not sufficient for requirement of test protocol, outside of container contaminated by specimen or patient not properly prepared for test.

  1. All specimens must meet the requirements before being accepted by the Laboratory. If you have any questions concerning requirements for certain tests, please consult your laboratory manual or call the Laboratory at 501-686-6230.
  2. If the specimen does not meet the above requirements, the following steps will be taken.
    1. The requesting physician or the patient's primary nurse will be contacted to define the problem.
    2. The following criteria will be used to explain what is needed to correct the problem:
       
    • Specimens submitted in the improper tube or container cannot be accepted. The submitting physician or nursing station will be asked to recollect the specimen in the proper container.
    • Specimens not accompanied by a requisition cannot be accepted. A properly completed request must be submitted.
    • Unlabeled specimens cannot be accepted. The submitting physician or nursing station will be expected to submit a fresh properly labeled specimen. For critical specimens (i.e. CSF, Body Fluids, Trough and Peak), the collector must personally identify the sample and sign a witnessed voucher.
    • Leaking containers cannot be accepted. The submitting physician or nursing station will be asked to submit a fresh specimen in the proper container, with a new request form if soiled. (Critical specimens, i.e., CSF or body fluids cannot be rejected. Wearing gloves, lab personnel should clean the outside of the container with 10% bleach solution).
    • Soiled requisition forms (specimens received with an accession form soiled or wet with fixative, blood or any other fluid). The submitting physician or nursing station will be notified, requested to prepare a clean requisition form and sign an incident form.
    • Specimens in syringes with needles attached cannot be accepted. Needles must be removed and the syringe capped before delivery to the Laboratory.
    • Other conditions for non-acceptance include: insufficient quantity of specimen containers received "empty", improper storage (i.e. incorrect fixative, no fixative, not on ice, etc.). These specimens will not be accepted until the submitted physician or nursing station is notified.
    • Specimens with requisitions that DO NOT contain required information (Dr.'s name, phone or pager #, diagnosis) will be held until the requisition is brought into regulatory compliance except in the case of life-threatening events.
    • If specimens have highly suspicious lab results indicative of possible IV contamination, the submitting physician or nursing
      station will be asked to recollect and submit the specimen to the lab.  This is to confirm the abnormal results.  The lab will
      not report suspicious results until the results have been confirmed by re-draw.  The pathology resident may be consulted
      to address concerns.

Contingencies

  1. If the ordering physician or attending nurse cannot be contacted, the location listed on the request will be telephoned to identify the problem.  The attending physician will be contacted if unable to reach the attending nurse or patient has been discharged.

  2. If contact cannot be made to either physician or location, the Pathology resident (Pager 501-688-2820) will be notified.

 

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