Acta Scientific Medical Sciences (ASMS)(ISSN: 2582-0931)

Research Article Volume 8 Issue 6

Laboratory Sample Collection Errors at Namibia Institute of Pathology Among State Doctors and Nurses, Erongo Region, Namibia

Sheehama Jacob*, Genovefa Sheehama and Selma Uushona

Department of Human, Biological and Translational Medical Sciences, University of Namibia, Namibia

*Corresponding Author: Sheehama Jacob, Department of Human, Biological and Translational Medical Sciences, University of Namibia, Namibia.

Received: July 18, 2023; Published: May 30, 2024


Clinical laboratory is the epicenter of health care sector and because patient management depends on the laboratory services, it is significant that the quality of these services is guaranteed. However, in the laboratory setting, blood specimens may be rejected for a variety of reasons, which may have substantial clinical consequences for the patient safety. The pre-analytical phase which is outside of the laboratory and beyond the control of the laboratory professionals has been highlighted as the leading contributor of diagnostics errors rates, accounting for 70% of errors in the laboratory. This study aimed to determine the major causes of pre-analytical errors because of sample collection among clinicians in Erongo Region.

The cross-sectional quantitative study was conducted among the state doctors and nurses at district hospitals in Erongo Region with a sample size of 14 doctors and 153 Nurses. The study further assessed the data of sample rejections recorded at the four of the Namibia Institute of Pathology (NIP) laboratories within the Erongo region, in 2020 and 2021. The data was collected and analyzed using Statistical Package for Social Science (SPSS) 25.0 program.

During the two year period (2020–2021), NIP Walvis Bay had a significant improvement (38.4%) of sample rejections in 2021 as compared to 2020, however, the laboratory recorded the highest rejection rates in comparison to the other laboratories in the region. Missing specimen/ no specimen received had been the most predominant reason for sample rejections among the laboratories in the region accounting for 21.2% and 28.5% of rejected samples in 2020 and 2021 respectively. Lack of specimen collecting materials had an influence on the sample rejections.

To reduce the sample rejections, NIP need to focus on strengthening the relationship with the clinicians by constantly providing adequate training and education and ensure the availability of sufficient materials required in the collection of patients’ samples by the district clinicians. It is further recommended that the clinicians engage or consult with the laboratories to seek clarity on the collection and handling of samples to avoid more sample rejections.

 Keywords: Pre-Analytical Errors; Sample Rejections; Rejection Rate; Sample Collection; Specimen


    1. Chawla R., et al. “Evaluating laboratory performance with quality indicators”. Laboratory Medicine5 (2010): 297-300.
    2. Plebani M. “Quality Indicators to Detect Pre-Analytical Errors in Laboratory Testing”. The Clinical Biochemist Reviews 3 (2012): 85-88.
    3. Plebani M. “The detection and prevention of errors in the laboratory medicine”. Annals of Clinical Biochemistry 47 (2010): 101-110.
    4. Da Rin “Pre-analytical workstations: A tool for reducing laboratory errors”. Clinica Acta 404.1 (2009): 68-74.
    5. Plebani M. “Errors in clinical laboratories or errors in laboratory medicine?”. European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)6 (2006).
    6. Plebania M., et al. “Quality indicators to detect pre-analytical errors in laboratory testing”. Clinica Chimica Acta15 (2014): 44-48.
    7. Cakirca G. “The Evaluation of Error Types and Turnaround Time of Preanalytical Phase in Biochemistry and Hematology Laboratories”. Iranian Journal of Pathology 2 (2018): 173-178.
    8. Arslan FD., et al. “The Effects of Education and Training Given to Phlebotomists for Reducing Preanalytical Errors”. Journal of Medical Biochemistry 2 (2018): 172-180.
    9. World Health Organization (WHO). Laboratory quality management system: handbook. WHO library Cataloguing-in-Publication Data (2011).
    10. Chawla R., et al. “Identification of the types of preanalytical errors in the clinical chemistry laboratory: 1-year study at GB Pant Hospital”. Laboratory Medicine2 (2010): 89-92.
    11. Jacobz LA., et al. “Chemistry and Haematology sample rejection and clinical impact in tertiary laboratory in Cape Town”. Clinical Chemistry and Laboratory Medicine 12 (2011): 2047-2050.
    12. Bonini P., et al. “Errors in Laboratory Medicine”. Clinical Chemistry5 (2011): 691-698.
    13. Guimaraes AC., et al. “Causes of rejection of blood samples handled in the clinical laboratory of a University Hospital in Porto Alegre”. Clinical Biochemistry1-2 (2011): 123-126.
    14. Namibia Institute of Pathology (NIP). Pareto Analysis sample rejection. ID5062153. Rec-017-02. 2019. Monthly reports (2019).
    15. Kamal F., et al. “Analysis of Sample Rejection and the Impact on Quality of Care in Patients in a Single Tertiary Healthcare Facility in Malaysia”. 8Th AMER International Conference on Quality of life. Lisbon  Malacca Port Cities Twin Conferences 2019 / 2020.
    16. Mosha VV and Kabanyana C. The rate of sample rejection and pre-analytical errors at KCMC Clinical Laboratory in Moshi, Kilimanjaro. The East African Health Research Commission 2021. The East African Science (2021).
    17. Gupta P., et al. “A Quality Improvement Initiative to Reduce Rejected Laboratory Samples and Enhance Specimen Acceptability". Joint Commission Journal on Quality and Patient Safety8 (2021).
    18. Tankeshwar A. “Rejection Criteria for Microbiological Specimens”. Bacteriology, Laboratory Diagnosis of Bacterial Disease (2021).
    19. OAML Ontarid Association of Medical Laboratories. Guidelines for the rejection of specimens. Community Laboaratory Guidelines, CLP 011-001. March (2007).
    20. Namibia Institute of Pathology (NIP). NIP laboratory Service Manual. Version 2. NIPLSM-001: laboratory service manual.
    21. Sepetiene R., et al. “Plasma for Laboratory Diagnostics” (2018).
    22. Shiferaw MB., et al. “Specimen rejections among referred specimens through referral network to the Amhara Public Health Institute for laboratory testing, Bahir Dar, Ethiopia”. BMC Research Notes 11 (2018): 781.
    23. Rooper L., et al. “Targeting Rejection: Analysis of Specimen Acceptability and Rejection, and Framework for Identifying Interventions in a Single Tertiary Healthcare Facility”. Journal of Clinical Laboratory Analysis 3 (2017): e22060.
    24. Celik S., et al. “How to decrease the rejection rates: reasons of sample rejection and solutions”. Turkish Journal of Biochemistry1 (2018).
    25. Dikmen ZG., et al. “Specimen rejection in laboratory medicine: Necessary for patient safety?” Biochemistry Medicine (Zagreb)3 (2015): 377-385.
    26. Dilshika LKM., et al. “A Study on Sample Rejection Rates due to Pre-analytical Errors: Associated Factors and Knowledge, Attitudes and Practices of Nurses on Blood Sample Collection for Haematology at a Teaching Hospital in Sri Lanka”. Journal of Health Sciences and Innovative Research1 (2020): 24-30.


    Citation: Sheehama Jacob., et al. “Laboratory Sample Collection Errors at Namibia Institute of Pathology Among State Doctors and Nurses, Erongo Region, Namibia”.Acta Scientific Medical Sciences 8.6 (2024): 133-142.


    Copyright: © 2024 Sheehama Jacob., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Acceptance rate30%
Acceptance to publication20-30 days
Impact Factor1.403

Indexed In

News and Events

  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is July 30, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US