临床基础检验室不合格标本的拒收与纠正措施

目的：通过对临床基础检验室不合格标本的数量及相应的拒收原因的分析，采取相应的纠正措施，完善实验室检验前管理，保证检验前质量控制，提高检验效率。方法：对2012年临床基础检验室不合格标本的拒收原因、数量及不合格率进行回顾性分析。结果：2012年1月、6月不合格标本数分别为605，865份；不合格率分别为1．2％，1．3％；其它月份不合格率均小于1％，下半年明显优于上半年；年度不合格标本总数为6028份，不合格率为0．82％。按照不合格标本拒收原因类型统计（年度）：样本无采集时间数量为2449份，占不合格标本的40．63％；标本凝固数量为717份，占不合格标本的11．89％；标本量不足数量为556份，占不合格标本的9．22％；非本实验室标本数量为682份，占不合格标本的11．31％；医嘱停止数量为553份，占不合格标本的9．17％；样本号已占用数量为632分，占不合格标本的10．48％；其他（条码不清、信息错误、样本重复等）数量为439份，占不合格标本的7．28％。结论：采取培训、沟通及绩效考核方法纠正措施，有助于保证检验前质量控制，缩短检验时间，提高检验效率。

The Rejection and Prevention of Unacceptable Specimens in Clinical Laboratory

Objective： To improve pre-analytical management, decrease laboratory error and enhance clinical laboratory working efficiency by the detection and prevention of unacceptable specimens. Methods： Retrospective analysis was conducted by the counting of unacceptable specimens for different reasons throughout the year of 2012. Results： The number of unqualified specimens on Jan and Jun was 605 and 865 respectively, with the unqualified rate of 1.2% and 1.3%. All the other months we less than 1%, with an obvious reduce in the latter 6 months comparing to the first 6 months, and the total number of this year＇s unacceptable speci- mens was 6 028 accounting for O. 82%. With in all these unacceptable samples throughout the year, 2 449 samples were rejected for the lack of sampling time accounting 40. 63%, 717 samples could not be analyzed for clotting before analysis accounting for 11.89%, 556 specimens were rejected for sample volume insufficiency accounting for 9.22%, 682 specimens were returned back for sending to the wrong lab, accounting for 11.31%, 553 samples were not adopted for the ceasing of order, 632 samples were rejected for sharing the same sample number with previous samples （wrong tagging） accounting for 10. 48%, other reasons （illegible tag, wrong information, duplicated samples） accounting for 7. 28% with the total number of 439. Conclusions： Education of staff, communication and oerformance aopraisal show ~eat capacity of decreasing total analysis time and improving working efficiency of clinical laboratories.