[A project to reduce rejection of newborn screening blood specimens for congenital metabolic diseases].

Defective blood specimens used to screen congenital metabolic diseases in newborns cause specimens to be rejected and necessitate that a heel stick be performed again. Such results in delayed diagnoses and family complaints. The purpose of this project was to reduce the incidence of blood specimen rejection. The project was carried out from March 1, 2006 to February 28, 2007. Project team members identified the causes of specimen problems using onsite observation, document review and quizzes on specimen collection knowledge. Three causes were found, including incorrect blood collection procedures, lack of pre-job training and continuing education, and disorganized blood collection work station. Five strategies were proposed to reduce the rejection of blood specimens: (1) establish standard operating procedures for blood specimen collection done to screen for congenital metabolic diseases; (2) design blood specimen collection training courses; (3) make a list of common errors encountered in blood specimen collection; (4) designate a specific person to organize the work station and (5) maintain an accurate monthly record of specimens rejected. After the completion of the project, the objective was achieved. The percentage of the rejected specimens fell from 19.5% to 3.8% per month and nurse scores on specimen collection knowledge increased from 68 to 92. In order to ensure the correctness of blood specimen collection, appropriate pre-job training and periodical on-job training courses for staff are further suggested.