Laboratory Professionals Member Community

Each lab must have a defined specimen rejection protocol and procedures for actions to be taken. These range from improper specimen labeling to quality of specimen collected. As far as CBC, no clotted specimen should ever be used. This includes any clotting appearing in the lid or strings in the specimen itself. A simple transit of an applicator stick through the specimen would reveal even a small clot (which is now in competition with the EDTA). The RBC and platelet counts are immediately affected and continue to be markedly affected further with each passing minute. The answer is always recollection. These issues seem to arise more frequently with improper specimen handling immediately after phlebotomy with insufficient mixing with the EDTA in the tube. Additional training of the nurse or phlebotomist is the follow up action. Any thought of deviating from this specimen rejection process could affect patient care causing unnecessary transfusion of blood products and would then be considered a major error. This is lab 101. 

Our lab has recently started a quality project with our NICU to reduce the number of clotted specimens received from the unit. I would like to ask if anyone works in a facility that has a NICU and how you have addressed this issue.