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Background <p>The preanalytical phase is considered the most error-prone part of laboratory testing and significantly contributes to medical errors. Specimen rejections during this phase can delay diagnosis and treatment, compromise patient safety, and increase healthcare costs. Understanding the causes of these rejections is essential for quality improvement.</p> Objectives <p>This study aimed to determine specimen rejection rates during the preanalytical phase and to explore nurses’ experiences related to these rejections.</p> Methods <p>A mixed-methods design was used. In the quantitative phase, one-year retrospective data were collected from the microbiology and biochemistry laboratories of a university hospital. In the qualitative phase, individual in-depth interviews were conducted with nurses working in clinics with the highest rejection rates. Thematic analysis was used to evaluate qualitative data.</p> Results <p>A total of 14,290 specimens were rejected in the biochemistry laboratory and 4,220 in the microbiology laboratory. The most frequent reasons for rejection were insufficient volume, hemolysis, and coagulation. Three main themes emerged from the interviews: [<CitationRef CitationID="CR1">1</CitationRef>] challenges in the preanalytical process [<CitationRef CitationID="CR2">2</CitationRef>], contributing factors to errors, and [<CitationRef CitationID="CR3">3</CitationRef>] emotional impact on nurses. Nurses highlighted issues such as lack of institutional support, inadequate training, patient cooperation difficulties, communication gaps, and stressful work environments. Emotional consequences included frustration, fatigue, and anxiety.</p> Conclusion <p>Preanalytical errors result from a combination of institutional, interpersonal, and environmental factors. These errors not only affect lab performance but also harm nurses’ psychological well-being. Interventions should aim to improve workflow, enhance training, and offer emotional support to reduce rejection rates and promote patient safety.</p> Clinical trial registration <p>Not applicable.</p>

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Evaluation of specimen rejection rates in the preanalytical phase and nurses’ experiences: a mixed design study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月1日

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  • Yasemin Güner,
  • Elif Kılıç Güner,
  • Melek Üçüncüoğlu,
  • Harun Yüksel

摘要

Background

The preanalytical phase is considered the most error-prone part of laboratory testing and significantly contributes to medical errors. Specimen rejections during this phase can delay diagnosis and treatment, compromise patient safety, and increase healthcare costs. Understanding the causes of these rejections is essential for quality improvement.

Objectives

This study aimed to determine specimen rejection rates during the preanalytical phase and to explore nurses’ experiences related to these rejections.

Methods

A mixed-methods design was used. In the quantitative phase, one-year retrospective data were collected from the microbiology and biochemistry laboratories of a university hospital. In the qualitative phase, individual in-depth interviews were conducted with nurses working in clinics with the highest rejection rates. Thematic analysis was used to evaluate qualitative data.

Results

A total of 14,290 specimens were rejected in the biochemistry laboratory and 4,220 in the microbiology laboratory. The most frequent reasons for rejection were insufficient volume, hemolysis, and coagulation. Three main themes emerged from the interviews: [1] challenges in the preanalytical process [2], contributing factors to errors, and [3] emotional impact on nurses. Nurses highlighted issues such as lack of institutional support, inadequate training, patient cooperation difficulties, communication gaps, and stressful work environments. Emotional consequences included frustration, fatigue, and anxiety.

Conclusion

Preanalytical errors result from a combination of institutional, interpersonal, and environmental factors. These errors not only affect lab performance but also harm nurses’ psychological well-being. Interventions should aim to improve workflow, enhance training, and offer emotional support to reduce rejection rates and promote patient safety.

Clinical trial registration

Not applicable.