Evaluation of Laboratory Request Form Variables as Filled by Clinicians at Msambweni County Referral Hospital, Kwale County, Kenya. 

Evaluation of Laboratory Request Form Variables as Filled by Clinicians at Msambweni County Referral Hospital, Kwale County, Kenya. | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Evaluation of Laboratory Request Form Variables as Filled by Clinicians at Msambweni County Referral Hospital, Kwale County, Kenya. Gibson Waweru Nyamu, Onesmus Oduori Ochieng', Peter Kitemi Wahome, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4316954/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Communication between clinicians and the laboratory staff occur via laboratory request forms (LRFs). Proper utilization of these forms enhances operational efficiency in healthcare by providing patients' samples along with their bio data and clinical details. This study aimed to assess the level of completion of LRFs at Msambweni County Referral Hospital- clinical laboratory (MCRHCL). Methods This study assessed the variables entered on LRFs that were sent to the MCRHCL during the month of February 2022. The checklist was used to audit the presence or absent of the following variables; patient name, sex, age, telephone contact of patient and requesting clinician, patients’ hospital number, patient residence, destination (clinicians’ location), name of doctor, type of specimen, time and date of collection, investigation required, clinical history and provisional diagnosis in LRFs. Data was collected and analyzed using in Epi Info 7 where descriptive statistics were calculated. Results Out of 272 sampled LRFs, none contained complete information for all required parameters. Patient name and requested test fields were fully and accurately completed for all patients. Patient age, gender, and the name of the requesting clinician were provided and accurately recorded on over 98% of the LRFs. However, there was a notable deficiency in recording the time of specimen collection, with percentages of 0.0%, for patient and clinician telephone contacts, 0.74%, and 1.47%, respectively. Conclusion Clinicians may lack awareness of the significance of completing LRFs adequately. Therefore, regular orientation programs should be implemented to enhance the effectiveness of LRFs completion. Background The laboratory request forms (LRFs) submitted to the laboratory serve as a crucial link between laboratory staff and overseeing clinicians who rely on the results provided by the laboratory for effective management and decision-making [ 1 , 2 ]. While laboratory expenses might make up just a small portion, around 5%, of a hospital's overall budget, they play a disproportionately significant role, influencing 60–70% of crucial decisions like admitting patients to the hospital, prescribing medications, determining length of stay, and facilitating discharge [ 3 ]. Laboratory professionals need patients' bio data, clinical symptoms, and laboratory results to arrive at a consensus in diagnosing and treating patients effectively [ 4 – 6 ]. Clinicians often underestimate the significance of thoroughly filling out LRFs, which can lead to laboratory staff having difficulty accurately interpreting results. This can result in incorrect allocation and delivery of patient results, causing delays in promptly initiating treatment [ 7 – 9 ]. Research indicates that pre-analytical errors have become the primary concern in laboratory testing, with incompletely filled request forms being the leading contributor to these errors [ 7 – 11 ]. Therefore, experts recommend that healthcare facilities regularly review "work processes" against measurable standards to identify deficiencies and suggest corrective actions to enhance patient care and well-being [ 12 , 13 ]. As clinicians' roles become increasingly varied, their inclination to overlook routine tasks can be detrimental. Nevertheless, they must uphold the practice of thoroughly completing LRFs, which is heavily reliant on the policies of the healthcare facility. In this regard, the current study aimed to assess the level of completion of LRFs at Msambweni County Referral Hospital- clinical laboratory (MCRHCL). The key findings of this study will be shared with the hospital administration to assist in implementing control measures. Methods Study site Kwale County is located in the former Coast Province of Kenya, is one of six counties in that region. It has a population of 866,820, consisting of 425,121 males, 441,681 females, and 18 individuals identified as intersex [ 14 ]. The County spans an area of 8,270.3 km 2 and shares borders with the Republic of Tanzania to the southwest, as well as Taita Taveta County to the west, Kilifi County to the north, Mombasa County to the northeast, and the Indian Ocean to the east. Being the main referral hospital in the county it serves about 800 people per day with both outpatient special clinics including Tuberculosis, Ear, Nose and Throat, orthopedic, dermatology, and Maternal and Child Health and inpatient department with a bed capacity of 240 beds. The Msambweni County Referral Hospital (MCRH) (Fig. 1 ) is found in Vingujini location, Vingujini sub-location, Ramisi Ward, and Msambweni sub-County. Study design and sampling procedure This study adopted descriptive cross-sectional study design where the LRFs submitted to the MCRHCL were systematic random sampling method was employed to select study participants with LRFs. Our sampling interval was based on patient reception as from 8.00 AM in the morning daily, from 28th January to 26th February 2022. The sampling started by picking the first LRF received daily and then every n th participant in the sampling frame was selected. The n th interval was determined by multiplying the average number of received LRFs per day by number of days then divided by the sample size so as to get LRFs required per day. We sampled our study participants until we arrived at our desired sample size of 272. n = x/y Where x was the population size (per day) by number of days and y was the sample size. By the use of this procedure each request form has a known and equal probability of being selected. Inclusion and exclusion criteria The study included LRFs from both in-patient and out-patient cases submitted to MCRHCL. It specifically excluded LRFs from other facilities brought by referred patients for testing, as well as those received outside of regular working hours (8:00 AM − 5:00 PM) and during weekends. Sample size determination Cochran's formula [ 15 ] was used to calculate sample size required to estimate the completeness of filling of the LRFs among patients who were requested for investigations at the MCRHCL. Where; n = desired sample size z = corresponding value of confidence level of 95% in the normal distribution table which is 1.96 p = proportion of the LRFs completely filled 23% [ 16 ] q= (1-p) proportion of laboratory request forms not completely filled 77% d = degree of precision 0.05% n = 1.96²×0.23×0.77/0.05² n = 272 Data collection We examined the information included in LRFs submitted to the MCRHCL in February 2022. This examination involved a checklist to confirm whether certain variables were present or not. These variables included the patient's name, gender, age, contact telephone (both patient and clinician), in/out patient number (IP/OP number), patient resident, clinician's location, attending clinician's name, specimen type, collection date and time, required investigation, clinical information, and provisional diagnosis documented in the LRFs. Data analysis The data were entered into Microsoft 365, cleaned, and double-checked before analysis using the Epi-info 7 statistical package (CDC, Atlanta, USA). Frequencies and proportions were calculated for categorical variables. Ethical consideration This study was approved by the Technical University of Mombasa Ethics Review Committee (TUM ERC BSC/057/2021). Furthermore, we sought permission to conduct the study from the Kwale County Department of Health (CG/KWL/6/5/1/CECM/39/Vol/1/33) and the Clinical Laboratory manager. The name (s) in the LRFs was not included during data entry and analysis. Results We assessed 272 LRFs received at the MCRHCL to determine their completeness. Among these, the doctor's location was specified on 216 out of 272 (79.6%) LRFs. Out of these, 156 (72.2%) were from outpatient cases and 60 (27.8%) were from inpatient cases (Table 1 ). However, 56 out of 272 (20.4%) LRFs did not include the clinician's location. Table 1 Proportion of Laboratory Request Forms categorized by their location (n = 216) Department/location Frequency Percent (%) Accident and Emergency 72 33.33 Outpatient clinic 66 30.56 Maternity Ward 18 8.33 Maternal and Child Clinic 18 8.33 Male Ward 15 6.94 Female Ward 13 6.02 Pediatric Ward 10 4.63 New Born Unit 4 1.85 Patient age, gender, and the name of the requesting clinician were provided and accurately recorded on over 98% of the LRFs. However, there was a notable deficiency in recording the time of specimen collection, with percentages of 0.0%, for patient and clinician telephone contacts, 0.74%, and 1.47%, respectively (Table 2 ). Table 2 Proportion of the laboratory request forms with the required information (n = 272) Information required Present (n) Percent (%) Patient name 272 100 Patient sex 270 99.26 Investigation requested 272 100 Age 269 98.9 Clinician name 267 98.16 Patient residence 220 80.88 Type of specimen required 221 81.25 Out/In patient number 206 75.74 Date of specimen collection 165 60.66 Provisional diagnosis 134 49.26 Clinical history 19 6.99 Patient telephone contact 2 0.74 Clinician telephone contact 4 1.47 Time of specimen collection 0 0 Location of the patient/department 216 79.41 Discussion This study represents the initial attempt in our clinical laboratory to assess the completeness of the LRFs completed by clinicians from different departments at MCRH. None of the evaluated 272 LRFs contained all the required information; rather, the remaining forms were missing one or more of the essential parameters, this is in tandem with a study done in Nigeria laboratory [ 17 ]. However, patient name (100%) and requested tests (100%) were recorded in all evaluated LRFs. Comparable findings regarding patient names have been reported in various studies [ 1 , 2 , 18 , 19 ]. Remarkably, in terms of the unique identification of patients through their outpatient or inpatient numbers, three-quarters (75.74%) of the LRFs were completed. This is in contrast with other studies which all LRFs evaluated were 100% filled [ 1 , 2 , 18 , 19 ]. The significance of the hospital number cannot be overstated in patient identification, especially considering the potential for patients to share identical or similar first names and surnames. The current study showed that patient age was present in 98.16% of laboratory request forms, while patient sex was included in 99.26% of them. This aligns closely with findings from a study conducted at Moi and Teaching Referral Hospital in western Kenya, where age and sex were present on 98.3% and 99.7% of forms respectively [ 2 ]. Comparable results were also reported in studies conducted in Nigeria and Tanzania [ 1 , 19 ]. The inclusion of patient demographic data is crucial for physicians, aiding in the appropriate interpretation of certain tests such as complete blood count, where reference intervals are age and sex specific. Additionally, certain diseases exhibit prevalence in particular age groups, further underscoring the importance of capturing patient demographic information. The recording of specimen collection dates was found in 60.66% of the LRFs, which is notably lower than the rates reported in a study conducted in Kenya (95.5%) [ 2 ], and another in Nigeria (99.5%) [ 1 ]. Interestingly, none (0.0%) of the LRFs included the time of specimen collection. Comparable results have been documented in different laboratory settings, with Ghana reporting 0.0% [ 20 ], Nigeria noting 0.7%[ 18 ], and Tanzania observing 1.5% [ 19 ]. The timing of specimen collection, including the date and time, holds significance as delays in delivering certain specimens can influence test results. For instance, a delay in delivering blood specimens may cause alterations in the storage conditions of blood cells, potentially complicating the interpretation of test results[ 21 , 22 ]. Furthermore, this data becomes essential when assessing turnaround times or addressing complaints related to reporting delays. Information regarding the patient's location or department (ward/clinic) was included in 79.41% of the LRFs. Similar findings were reported by Makubi et al., with a rate of 86.75%[ 19 ], although Olayemi and Asiamah-Broni reported a lower percentage of 52.2% [ 20 ]. Several authors have reported higher proportions ranging from 95.1–100% [ 1 , 2 , 7 , 23 ]. The inclusion of location information is crucial as it facilitates the tracking of both the patient and the attending clinician, ensuring timely delivery of test results. This becomes particularly vital in situations involving critical test results that necessitate urgent action by the attending clinician. This study reveals that 49.26% of the LRFs included provisional diagnosis, while clinical history was documented in 6.99% of them. These findings differ from those of other studies, such as Kipkulei and Lotodo with 85.8%[ 2 ], Jegede et al. with 80.9% [ 1 ], and Nutt et al. with 80.9%[ 23 ], which reported higher proportions. Supplying sufficient clinical information has been shown to assist in the accurate interpretation of test results and to prevent unnecessary investigations [ 24 , 25 ]. The lack of clinical information or the provision of misleading data can result in additional, unnecessary tests and subsequent unwarranted costs. Moreover, insufficient clinical information may lead to misinterpretations and potentially harmful conclusions drawn from laboratory results [ 26 ]. In 98.9% of the assessed LRFs, the clinician's name was provided, while only 1.47% included the clinician's mobile telephone number. These results are comparable to those reported by Kipkulei and Lotodo at 96.9% [ 2 ], Jegede et al. at 90.1%[ 1 ], and Oyelekan et al. at 93.8%[ 18 ] regarding the inclusion of clinician names. However, a lower percentage were reported by Makubi et al., with a rate of 88.7%[ 19 ], and, Olayemi and Asiamah-Broni reported 55.2% [ 20 ] in regard to inclusion of clinician names in the LRFs. Clinicians' contact information is essential for situations requiring follow-up or communication of critical test results. The current study may have a few limitations; 1) we did not consult the clinicians responsible for filling out the LRFs. Their input could have provided further understanding of the factors contributing to incomplete forms. 2) Furthermore, the LRFs were not categorized based on the ordering clinician's rank (such as registered nurse, registered clinical officer intern, registered clinical officer, medical intern, medical officer, or consultant), which could have shed light on any correlation between clinician rank and the completeness of request form submissions. Conclusion The current study revealed inadequacies in recording necessary information on LRFs. Patient name and investigation requested were consistently and adequately filled out, while time of specimen collection, clinician and patient telephone number were notably had lower completion rates. This shortfall could have adverse effects on result interpretation, prompt communication of critical values, turnaround times, and ultimately patient care quality. Investigating the reasons behind clinicians' incomplete filling of these forms is crucial. Additionally, raising clinician awareness through continuous medical education on the significance of thorough completion of LRFs is imperative to enhance patient care. Abbreviations IP In patient LRFs Laboratory Request Forms MCRH Msambweni County Referral Hospital MCRHCL Msambweni County Referral Hospital Clinical Laboratory OP Out patient TUM Technical University of Mombasa Declarations Author Contributions Statement Conceptualization: GWN, OOO, RNW, PKW, JMK, FO, Data curation: GWN, OOO, RNW, PKW, Formal analysis: GWN. Investigation: GWN, OOO, RNW, PKW. Methodology: GWN, OOO, RNW, PKW, JMK, FO, Supervision: GWN, RTK, RNW, PKW, Validation: GWN, OOO, RNW, PKW, JMK, FO, Visualization: GWN, OOO, RNW, PKW, JMK, FO, Writing – original draft: GWN, OOO, RNW, PKW Writing – review & editing: GWN,OOO, RNW, PKW, JMK, FO. Acknowledgements The authors would like to express their appreciation to the Technical University of Mombasa, Kenya, for their continuous support throughout the research. Special thanks are extended to the authorities at the Kwale County Department of Health for their collaboration. The authors also acknowledge Mr. Chimvua Kombo, the director of MCRH, for granting permission to conduct the study at their facility. Gratitude is further extended to the dedicated staff of the MCRH Clinical Laboratory, as well as Laboratory Manager Mr. Ali Musa, for their assistance in data collection. The authors deeply thank all the patients who volunteered to participate in the study; their invaluable contribution was essential in achieving these findings. Human Ethics and Consent to Participate declarations All study participants were either given a English or Kiswahili version of informed consent forms to read and give consent to participate in the study. For participants who were unable to read, a legal guardian read the consent form to them in Swahili and their thumbprint was used instead of a signature. Funding This study did not attract any grants or funding Competing interests The authors declares no competing interest Consent for publication All authors have given permission for publication of this manuscript Data availability The data sets utilized and/or examined in the present study can be obtained from the corresponding author upon request that is deemed reasonable (Uploaded as supplementary materials). References Jegede F, et al. Evaluating laboratory request forms submitted to haematology and blood transfusion departments at a hospital in Northwest Nigeria. Afr J Lab Med. 2016;5(1):1–6. Kipkulei JC, Lotodo TC. Evaluation of the completeness in the filling of laboratory request forms submitted to the haematology laboratory at a Tertiary Hospital in Kenya. Health. 2019;11(7):862–8. Forsman RW. Why is the laboratory an afterthought for managed care organizations? Clin Chem. 1996;42(5):813–6. Marshall WJ, Challand GS. Provision of interpretative comments on biochemical report forms. Ann Clin Biochem. 2000;37(6):758–63. Osegbe I, Afolabi O, Onyenekwu C. The effectiveness of clinician education on the adequate completion of laboratory test request forms at a tertiary hospital. Annals Med Health Sci Res. 2016;6(2):90–4. Burnett L, Chesher D, Mudaliar Y. Improving the quality of information on pathology request forms. Ann Clin Biochem. 2004;41(1):53–6. OA A, Idowu A, Jeje O. Incomplete laboratory request forms as a contributory factor to preanalytical errors in a Nigerian teaching hospital. Afr J Biochem Res. 2011;5(3):82–5. Forae GD, Obaseki DE. Adequacy of clinical information supplied by clinicians for histopathologic diagnosis: The university of Benin teaching hospital experince. New Nigerian J Clin Res. 2017;6(9):12. Adizua U. Incomplete Filling of Laboratory Request Forms: A Look at the Practice at a Federal Medical Centre in South Eastern Nigeria. West Afr J Med. 2019;36(2):112–5. Onyiaorah IV et al. Effect of remedial measures on inadequacies in the completion of laboratory request forms by clinicians. Clin Audit, 2012: p. 9–14. Carraro P, Plebani M. Errors in a stat laboratory: types and frequencies 10 years later. Clin Chem. 2007;53(7):1338–42. Walshe K. Principles for Best Practice in Clinical Audit: National Institute for Clinical Excellence. Abingdon, Oxon: Radcliffe Medical Press , 2002. £ 29.95 (£ 19.95 for NHS staff). 208 pp. ISBN 1 85775 976 1. Quality and Safety in Health Care, 2002. 11(4): pp. 392–392. Standardization IOf. Medical laboratories: particular requirements for quality and competence. International Organization for Standardization; 2007. KNBS K. Kenya Population and Housing Census Volume I: Population By County and Sub-County. Vol. I, 2019. 2019. Cochran WG. Sampling techniques. Wiley; 1977. Sharif MA, et al. Clinician's responsibility in pre-analytical quality assurance of histopathology. Pakistan J Med Sci. 2007;23(5):720. Ikponmwen O, et al. Evaluation of request forms submitted to Haematology Laboratory in a Rural Tertiary Hospital in South-South Nigeria. Annals Trop Pathol. 2013;4(2):21–4. Oyelekan AA, et al. Pattern of completion of Laboratory Request Forms in a tertiary health facility. Annals of Health Research (The Journal of the Medical and Dental Consultants Association of Nigeria. Nigeria). 2018;4(2):155–61. OOUTH, Sagamu. Makubi AN et al. Audit of clinical-laboratory practices in haematology and blood transfusion at Muhimbili National Hospital in Tanzania. Tanzan J health Res, 2012. 14(4). Olayemi E, Asiamah-Broni R. Evaluation of request forms submitted to the haematology laboratory in a Ghanaian tertiary hospital. Pan Afr Med J, 2011. 8(1). Zini Tanzi G. Stability of complete blood count parameters with storage: toward defined specifications for different diagnostic applications. International journal of laboratory hematology, 2013(Dicembre): p. N/A-N/A. Antwi-Baffour S, et al. Prolong storage of blood in EDTA has an effect on the morphology and osmotic fragility of erythrocytes. Int J Biomed Sci Eng. 2013;1(2):20–3. Nutt L, Zemlin AE, Erasmus RT. Incomplete laboratory request forms: the extent and impact on critical results at a tertiary hospital in South Africa. Ann Clin Biochem. 2008;45(5):463–6. Zemlin AE, et al. Potential for medical error: incorrectly completed request forms for thyroid function tests limit pathologists' advice to clinicians. SAMJ: South Afr Med J. 2009;99(9):668–71. Burton J, Stephenson T. Are clinicians failing to supply adequate information when requesting a histopathological investigation? J Clin Pathol. 2001;54(10):806–8. Plebani M. Errors in clinical laboratories or errors in laboratory medicine? Clin Chem Lab Med (CCLM). 2006;44(6):750–9. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4316954","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":296512128,"identity":"8fef6314-b3c3-4726-a0b5-8fff83b4ef57","order_by":0,"name":"Gibson Waweru Nyamu","email":"data:image/png;base64,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","orcid":"","institution":"Kwale County","correspondingAuthor":true,"prefix":"","firstName":"Gibson","middleName":"Waweru","lastName":"Nyamu","suffix":""},{"id":296512129,"identity":"2fde2557-2b18-4a7c-9bd3-b4669d94f0b5","order_by":1,"name":"Onesmus Oduori Ochieng'","email":"","orcid":"","institution":"Technical University of Mombasa","correspondingAuthor":false,"prefix":"","firstName":"Onesmus","middleName":"Oduori","lastName":"Ochieng'","suffix":""},{"id":296512130,"identity":"b4c4f12d-ea09-4dbe-9a64-13e69f275104","order_by":2,"name":"Peter Kitemi Wahome","email":"","orcid":"","institution":"Kwale County","correspondingAuthor":false,"prefix":"","firstName":"Peter","middleName":"Kitemi","lastName":"Wahome","suffix":""},{"id":296512131,"identity":"dd82a326-f4d1-457e-977e-e07c16a86dd6","order_by":3,"name":"Frendrick Odhiambo Odhiambo","email":"","orcid":"","institution":"Ministry of Health","correspondingAuthor":false,"prefix":"","firstName":"Frendrick","middleName":"Odhiambo","lastName":"Odhiambo","suffix":""},{"id":296512132,"identity":"f7a51e2d-54e6-4d5f-9169-862f68489ce4","order_by":4,"name":"Jacintah Mueni King’oo","email":"","orcid":"","institution":"Ministry of Health","correspondingAuthor":false,"prefix":"","firstName":"Jacintah","middleName":"Mueni","lastName":"King’oo","suffix":""},{"id":296512133,"identity":"95b97d00-99a1-4955-a5d2-cea18bab2349","order_by":5,"name":"Ronald Nyarambe Wigina","email":"","orcid":"","institution":"Technical University of Mombasa","correspondingAuthor":false,"prefix":"","firstName":"Ronald","middleName":"Nyarambe","lastName":"Wigina","suffix":""}],"badges":[],"createdAt":"2024-04-24 09:12:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4316954/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4316954/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":56016689,"identity":"8614a8c5-776b-4af1-8d91-5a8a397a0aa4","added_by":"auto","created_at":"2024-05-07 15:21:57","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":429840,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4316954/v1/fe8cb9cd-63b9-484b-bb49-c6c297064466.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Evaluation of Laboratory Request Form Variables as Filled by Clinicians at Msambweni County Referral Hospital, Kwale County, Kenya. ","fulltext":[{"header":"Background","content":"\u003cp\u003eThe laboratory request forms (LRFs) submitted to the laboratory serve as a crucial link between laboratory staff and overseeing clinicians who rely on the results provided by the laboratory for effective management and decision-making [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. While laboratory expenses might make up just a small portion, around 5%, of a hospital's overall budget, they play a disproportionately significant role, influencing 60\u0026ndash;70% of crucial decisions like admitting patients to the hospital, prescribing medications, determining length of stay, and facilitating discharge [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Laboratory professionals need patients' bio data, clinical symptoms, and laboratory results to arrive at a consensus in diagnosing and treating patients effectively [\u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eClinicians often underestimate the significance of thoroughly filling out LRFs, which can lead to laboratory staff having difficulty accurately interpreting results. This can result in incorrect allocation and delivery of patient results, causing delays in promptly initiating treatment [\u003cspan additionalcitationids=\"CR8\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Research indicates that pre-analytical errors have become the primary concern in laboratory testing, with incompletely filled request forms being the leading contributor to these errors [\u003cspan additionalcitationids=\"CR8 CR9 CR10\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Therefore, experts recommend that healthcare facilities regularly review \"work processes\" against measurable standards to identify deficiencies and suggest corrective actions to enhance patient care and well-being [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAs clinicians' roles become increasingly varied, their inclination to overlook routine tasks can be detrimental. Nevertheless, they must uphold the practice of thoroughly completing LRFs, which is heavily reliant on the policies of the healthcare facility. In this regard, the current study aimed to assess the level of completion of LRFs at Msambweni County Referral Hospital- clinical laboratory (MCRHCL). The key findings of this study will be shared with the hospital administration to assist in implementing control measures.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy site\u003c/h2\u003e \u003cp\u003eKwale County is located in the former Coast Province of Kenya, is one of six counties in that region. It has a population of 866,820, consisting of 425,121 males, 441,681 females, and 18 individuals identified as intersex [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. The County spans an area of 8,270.3 km\u003csup\u003e2\u003c/sup\u003e and shares borders with the Republic of Tanzania to the southwest, as well as Taita Taveta County to the west, Kilifi County to the north, Mombasa County to the northeast, and the Indian Ocean to the east. Being the main referral hospital in the county it serves about 800 people per day with both outpatient special clinics including Tuberculosis, Ear, Nose and Throat, orthopedic, dermatology, and Maternal and Child Health and inpatient department with a bed capacity of 240 beds. The Msambweni County Referral Hospital (MCRH) (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e) is found in Vingujini location, Vingujini sub-location, Ramisi Ward, and Msambweni sub-County.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eStudy design and sampling procedure\u003c/h2\u003e \u003cp\u003eThis study adopted descriptive cross-sectional study design where the LRFs submitted to the MCRHCL were systematic random sampling method was employed to select study participants with LRFs. Our sampling interval was based on patient reception as from 8.00 AM in the morning daily, from 28th January to 26th February 2022. The sampling started by picking the first LRF received daily and then every n\u003csup\u003eth\u003c/sup\u003e participant in the sampling frame was selected. The n\u003csup\u003eth\u003c/sup\u003e interval was determined by multiplying the average number of received LRFs per day by number of days then divided by the sample size so as to get LRFs required per day. We sampled our study participants until we arrived at our desired sample size of 272.\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;x/y\u003c/p\u003e \u003cp\u003eWhere x was the population size (per day) by number of days and y was the sample size.\u003c/p\u003e \u003cp\u003eBy the use of this procedure each request form has a known and equal probability of being selected.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eInclusion and exclusion criteria\u003c/h2\u003e \u003cp\u003eThe study included LRFs from both in-patient and out-patient cases submitted to MCRHCL. It specifically excluded LRFs from other facilities brought by referred patients for testing, as well as those received outside of regular working hours (8:00 AM \u0026minus;\u0026thinsp;5:00 PM) and during weekends.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eSample size determination\u003c/h2\u003e \u003cp\u003eCochran's formula [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e] was used to calculate sample size required to estimate the completeness of filling of the LRFs among patients who were requested for investigations at the MCRHCL.\u003c/p\u003e\u003cp\u003e\u003cimg src=\"https://myfiles.space/user_files/127393_c7e80a1c9bb65875/127393_custom_files/img1714723791.png\"\u003e\u003cbr\u003e\u003c/p\u003e\u003cp\u003eWhere;\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;desired sample size\u003c/p\u003e \u003cp\u003ez\u0026thinsp;=\u0026thinsp;corresponding value of confidence level of 95% in the normal distribution table which is 1.96\u003c/p\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;proportion of the LRFs completely filled 23% [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eq= (1-p) proportion of laboratory request forms not completely filled 77%\u003c/p\u003e \u003cp\u003ed\u0026thinsp;=\u0026thinsp;degree of precision 0.05%\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;1.96\u0026sup2;\u0026times;0.23\u0026times;0.77/0.05\u0026sup2;\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;272\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section3\"\u003e \u003ch2\u003eData collection\u003c/h2\u003e \u003cp\u003eWe examined the information included in LRFs submitted to the MCRHCL in February 2022. This examination involved a checklist to confirm whether certain variables were present or not. These variables included the patient's name, gender, age, contact telephone (both patient and clinician), in/out patient number (IP/OP number), patient resident, clinician's location, attending clinician's name, specimen type, collection date and time, required investigation, clinical information, and provisional diagnosis documented in the LRFs.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eData analysis\u003c/h2\u003e \u003cp\u003eThe data were entered into Microsoft 365, cleaned, and double-checked before analysis using the Epi-info 7 statistical package (CDC, Atlanta, USA). Frequencies and proportions were calculated for categorical variables.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eEthical consideration\u003c/h2\u003e \u003cp\u003e This study was approved by the Technical University of Mombasa Ethics Review Committee (TUM ERC BSC/057/2021). Furthermore, we sought permission to conduct the study from the Kwale County Department of Health (CG/KWL/6/5/1/CECM/39/Vol/1/33) and the Clinical Laboratory manager. The name (s) in the LRFs was not included during data entry and analysis.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eWe assessed 272 LRFs received at the MCRHCL to determine their completeness. Among these, the doctor's location was specified on 216 out of 272 (79.6%) LRFs. Out of these, 156 (72.2%) were from outpatient cases and 60 (27.8%) were from inpatient cases (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). However, 56 out of 272 (20.4%) LRFs did not include the clinician's location.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eProportion of Laboratory Request Forms categorized by their location (n\u0026thinsp;=\u0026thinsp;216)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDepartment/location\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAccident and Emergency\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33.33\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOutpatient clinic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30.56\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaternity Ward\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.33\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaternal and Child Clinic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.33\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale Ward\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.94\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale Ward\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.02\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePediatric Ward\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNew Born Unit\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.85\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003ePatient age, gender, and the name of the requesting clinician were provided and accurately recorded on over 98% of the LRFs. However, there was a notable deficiency in recording the time of specimen collection, with percentages of 0.0%, for patient and clinician telephone contacts, 0.74%, and 1.47%, respectively (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eProportion of the laboratory request forms with the required information (n\u0026thinsp;=\u0026thinsp;272)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInformation required\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePresent (n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePatient name\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e272\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePatient sex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e270\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e99.26\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInvestigation requested\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e272\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e269\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e98.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClinician name\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e267\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e98.16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePatient residence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e220\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e80.88\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType of specimen required\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e221\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e81.25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOut/In patient number\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e206\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e75.74\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDate of specimen collection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60.66\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProvisional diagnosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49.26\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClinical history\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.99\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePatient telephone contact\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.74\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClinician telephone contact\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.47\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTime of specimen collection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLocation of the patient/department\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e216\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e79.41\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study represents the initial attempt in our clinical laboratory to assess the completeness of the LRFs completed by clinicians from different departments at MCRH.\u003c/p\u003e \u003cp\u003eNone of the evaluated 272 LRFs contained all the required information; rather, the remaining forms were missing one or more of the essential parameters, this is in tandem with a study done in Nigeria laboratory [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. However, patient name (100%) and requested tests (100%) were recorded in all evaluated LRFs. Comparable findings regarding patient names have been reported in various studies [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Remarkably, in terms of the unique identification of patients through their outpatient or inpatient numbers, three-quarters (75.74%) of the LRFs were completed. This is in contrast with other studies which all LRFs evaluated were 100% filled [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. The significance of the hospital number cannot be overstated in patient identification, especially considering the potential for patients to share identical or similar first names and surnames.\u003c/p\u003e \u003cp\u003eThe current study showed that patient age was present in 98.16% of laboratory request forms, while patient sex was included in 99.26% of them. This aligns closely with findings from a study conducted at Moi and Teaching Referral Hospital in western Kenya, where age and sex were present on 98.3% and 99.7% of forms respectively [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Comparable results were also reported in studies conducted in Nigeria and Tanzania [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. The inclusion of patient demographic data is crucial for physicians, aiding in the appropriate interpretation of certain tests such as complete blood count, where reference intervals are age and sex specific. Additionally, certain diseases exhibit prevalence in particular age groups, further underscoring the importance of capturing patient demographic information.\u003c/p\u003e \u003cp\u003eThe recording of specimen collection dates was found in 60.66% of the LRFs, which is notably lower than the rates reported in a study conducted in Kenya (95.5%) [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e], and another in Nigeria (99.5%) [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Interestingly, none (0.0%) of the LRFs included the time of specimen collection. Comparable results have been documented in different laboratory settings, with Ghana reporting 0.0% [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e], Nigeria noting 0.7%[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], and Tanzania observing 1.5% [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. The timing of specimen collection, including the date and time, holds significance as delays in delivering certain specimens can influence test results. For instance, a delay in delivering blood specimens may cause alterations in the storage conditions of blood cells, potentially complicating the interpretation of test results[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Furthermore, this data becomes essential when assessing turnaround times or addressing complaints related to reporting delays.\u003c/p\u003e \u003cp\u003eInformation regarding the patient's location or department (ward/clinic) was included in 79.41% of the LRFs. Similar findings were reported by Makubi et al., with a rate of 86.75%[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], although Olayemi and Asiamah-Broni reported a lower percentage of 52.2% [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Several authors have reported higher proportions ranging from 95.1\u0026ndash;100% [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. The inclusion of location information is crucial as it facilitates the tracking of both the patient and the attending clinician, ensuring timely delivery of test results. This becomes particularly vital in situations involving critical test results that necessitate urgent action by the attending clinician.\u003c/p\u003e \u003cp\u003eThis study reveals that 49.26% of the LRFs included provisional diagnosis, while clinical history was documented in 6.99% of them. These findings differ from those of other studies, such as Kipkulei and Lotodo with 85.8%[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e], Jegede et al. with 80.9% [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e], and Nutt et al. with 80.9%[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e], which reported higher proportions. Supplying sufficient clinical information has been shown to assist in the accurate interpretation of test results and to prevent unnecessary investigations [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. The lack of clinical information or the provision of misleading data can result in additional, unnecessary tests and subsequent unwarranted costs. Moreover, insufficient clinical information may lead to misinterpretations and potentially harmful conclusions drawn from laboratory results [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn 98.9% of the assessed LRFs, the clinician's name was provided, while only 1.47% included the clinician's mobile telephone number. These results are comparable to those reported by Kipkulei and Lotodo at 96.9% [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e], Jegede et al. at 90.1%[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e], and Oyelekan et al. at 93.8%[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] regarding the inclusion of clinician names. However, a lower percentage were reported by Makubi et al., with a rate of 88.7%[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], and, Olayemi and Asiamah-Broni reported 55.2% [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] in regard to inclusion of clinician names in the LRFs. Clinicians' contact information is essential for situations requiring follow-up or communication of critical test results.\u003c/p\u003e \u003cp\u003eThe current study may have a few limitations; 1) we did not consult the clinicians responsible for filling out the LRFs. Their input could have provided further understanding of the factors contributing to incomplete forms. 2) Furthermore, the LRFs were not categorized based on the ordering clinician's rank (such as registered nurse, registered clinical officer intern, registered clinical officer, medical intern, medical officer, or consultant), which could have shed light on any correlation between clinician rank and the completeness of request form submissions.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe current study revealed inadequacies in recording necessary information on LRFs. Patient name and investigation requested were consistently and adequately filled out, while time of specimen collection, clinician and patient telephone number were notably had lower completion rates. This shortfall could have adverse effects on result interpretation, prompt communication of critical values, turnaround times, and ultimately patient care quality. Investigating the reasons behind clinicians' incomplete filling of these forms is crucial. Additionally, raising clinician awareness through continuous medical education on the significance of thorough completion of LRFs is imperative to enhance patient care.\u003c/p\u003e "},{"header":"Abbreviations","content":"\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"512\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"15.0390625%\" valign=\"bottom\"\u003e\n \u003cp\u003eIP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"84.9609375%\" valign=\"bottom\"\u003e\n \u003cp\u003eIn patient\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"15.0390625%\" valign=\"bottom\"\u003e\n \u003cp\u003eLRFs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"84.9609375%\" valign=\"bottom\"\u003e\n \u003cp\u003eLaboratory Request Forms\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"15.0390625%\" valign=\"bottom\"\u003e\n \u003cp\u003eMCRH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"84.9609375%\" valign=\"bottom\"\u003e\n \u003cp\u003eMsambweni County Referral Hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"15.0390625%\" valign=\"bottom\"\u003e\n \u003cp\u003eMCRHCL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"84.9609375%\" valign=\"bottom\"\u003e\n \u003cp\u003eMsambweni County Referral Hospital Clinical Laboratory\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"15.0390625%\" valign=\"bottom\"\u003e\n \u003cp\u003eOP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"84.9609375%\" valign=\"bottom\"\u003e\n \u003cp\u003eOut patient\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"15.0390625%\" valign=\"bottom\"\u003e\n \u003cp\u003eTUM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"84.9609375%\" valign=\"bottom\"\u003e\n \u003cp\u003eTechnical University of Mombasa\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthor Contributions Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceptualization: GWN, OOO, RNW, PKW, JMK, FO, Data curation: GWN, OOO, RNW, PKW, Formal analysis: GWN. Investigation: GWN, OOO, RNW, PKW. Methodology: GWN, OOO, RNW, PKW, JMK, FO, Supervision: GWN, RTK, RNW, PKW, Validation: GWN, OOO, RNW, PKW, JMK, FO, Visualization: GWN, OOO, RNW, PKW, JMK, FO, Writing \u0026ndash; original draft: GWN, OOO, RNW, PKW Writing \u0026ndash; review \u0026amp; editing: GWN,OOO, RNW, PKW, JMK, FO.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to express their appreciation to the Technical University of Mombasa, Kenya, for their continuous support throughout the research. Special thanks are extended to the authorities at the Kwale County Department of Health for their collaboration. The authors also acknowledge Mr. Chimvua Kombo, the director of MCRH, for granting permission to conduct the study at their facility. Gratitude is further extended to the dedicated staff of the MCRH Clinical Laboratory, as well as Laboratory Manager Mr. Ali Musa, for their assistance in data collection. The authors deeply thank all the patients who volunteered to participate in the study; their invaluable contribution was essential in achieving these findings.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHuman Ethics and Consent to Participate declarations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll study participants were either given a English or Kiswahili version of informed consent forms to read and \u0026nbsp;give consent to participate in the study. For participants who were unable to read, a legal guardian read the consent form to them in Swahili and their thumbprint was used instead of a signature.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study did not attract any grants or funding\u003c/p\u003e\n\u003ch3\u003eCompeting interests\u003c/h3\u003e\n\u003cp\u003eThe authors declares no competing interest\u003c/p\u003e\n\u003ch3\u003eConsent for publication\u003c/h3\u003e\n\u003cp\u003eAll authors have given permission for publication of this manuscript\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data sets utilized and/or examined in the present study can be obtained from the corresponding author upon request that is deemed reasonable (Uploaded as supplementary materials).\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eJegede F, et al. Evaluating laboratory request forms submitted to haematology and blood transfusion departments at a hospital in Northwest Nigeria. Afr J Lab Med. 2016;5(1):1\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKipkulei JC, Lotodo TC. Evaluation of the completeness in the filling of laboratory request forms submitted to the haematology laboratory at a Tertiary Hospital in Kenya. Health. 2019;11(7):862\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eForsman RW. Why is the laboratory an afterthought for managed care organizations? Clin Chem. 1996;42(5):813\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMarshall WJ, Challand GS. Provision of interpretative comments on biochemical report forms. Ann Clin Biochem. 2000;37(6):758\u0026ndash;63.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOsegbe I, Afolabi O, Onyenekwu C. The effectiveness of clinician education on the adequate completion of laboratory test request forms at a tertiary hospital. Annals Med Health Sci Res. 2016;6(2):90\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBurnett L, Chesher D, Mudaliar Y. Improving the quality of information on pathology request forms. Ann Clin Biochem. 2004;41(1):53\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOA A, Idowu A, Jeje O. Incomplete laboratory request forms as a contributory factor to preanalytical errors in a Nigerian teaching hospital. Afr J Biochem Res. 2011;5(3):82\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eForae GD, Obaseki DE. Adequacy of clinical information supplied by clinicians for histopathologic diagnosis: The university of Benin teaching hospital experince. New Nigerian J Clin Res. 2017;6(9):12.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAdizua U. Incomplete Filling of Laboratory Request Forms: A Look at the Practice at a Federal Medical Centre in South Eastern Nigeria. West Afr J Med. 2019;36(2):112\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOnyiaorah IV et al. Effect of remedial measures on inadequacies in the completion of laboratory request forms by clinicians. Clin Audit, 2012: p. 9\u0026ndash;14.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCarraro P, Plebani M. Errors in a stat laboratory: types and frequencies 10 years later. Clin Chem. 2007;53(7):1338\u0026ndash;42.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWalshe K. \u003cem\u003ePrinciples for Best Practice in Clinical Audit: National Institute for Clinical Excellence. Abingdon, Oxon: Radcliffe Medical Press\u003c/em\u003e, 2002.\u003cem\u003e\u0026pound; 29.95 (\u0026pound; 19.95 for NHS staff). 208 pp. ISBN 1 85775 976 1.\u003c/em\u003e Quality and Safety in Health Care, 2002. 11(4): pp. 392\u0026ndash;392.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStandardization IOf. Medical laboratories: particular requirements for quality and competence. International Organization for Standardization; 2007.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKNBS K. \u003cem\u003eKenya Population and Housing Census Volume I: Population By County and Sub-County.\u003c/em\u003e Vol. I, 2019. 2019.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCochran WG. Sampling techniques. Wiley; 1977.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSharif MA, et al. Clinician's responsibility in pre-analytical quality assurance of histopathology. Pakistan J Med Sci. 2007;23(5):720.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIkponmwen O, et al. Evaluation of request forms submitted to Haematology Laboratory in a Rural Tertiary Hospital in South-South Nigeria. Annals Trop Pathol. 2013;4(2):21\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOyelekan AA, et al. \u003cem\u003ePattern of completion of Laboratory Request Forms in a tertiary health facility.\u003c/em\u003e Annals of Health Research (The Journal of the Medical and Dental Consultants Association of Nigeria. Nigeria). 2018;4(2):155\u0026ndash;61. OOUTH, Sagamu.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMakubi AN et al. Audit of clinical-laboratory practices in haematology and blood transfusion at Muhimbili National Hospital in Tanzania. Tanzan J health Res, 2012. 14(4).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOlayemi E, Asiamah-Broni R. Evaluation of request forms submitted to the haematology laboratory in a Ghanaian tertiary hospital. Pan Afr Med J, 2011. 8(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZini Tanzi G. \u003cem\u003eStability of complete blood count parameters with storage: toward defined specifications for different diagnostic applications.\u003c/em\u003e International journal of laboratory hematology, 2013(Dicembre): p. N/A-N/A.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAntwi-Baffour S, et al. Prolong storage of blood in EDTA has an effect on the morphology and osmotic fragility of erythrocytes. Int J Biomed Sci Eng. 2013;1(2):20\u0026ndash;3.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNutt L, Zemlin AE, Erasmus RT. Incomplete laboratory request forms: the extent and impact on critical results at a tertiary hospital in South Africa. Ann Clin Biochem. 2008;45(5):463\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZemlin AE, et al. Potential for medical error: incorrectly completed request forms for thyroid function tests limit pathologists' advice to clinicians. SAMJ: South Afr Med J. 2009;99(9):668\u0026ndash;71.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBurton J, Stephenson T. Are clinicians failing to supply adequate information when requesting a histopathological investigation? J Clin Pathol. 2001;54(10):806\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePlebani M. Errors in clinical laboratories or errors in laboratory medicine? Clin Chem Lab Med (CCLM). 2006;44(6):750\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-4316954/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4316954/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eCommunication between clinicians and the laboratory staff occur via laboratory request forms (LRFs). Proper utilization of these forms enhances operational efficiency in healthcare by providing patients' samples along with their bio data and clinical details. This study aimed to assess the level of completion of LRFs at Msambweni County Referral Hospital- clinical laboratory (MCRHCL).\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis study assessed the variables entered on LRFs that were sent to the MCRHCL during the month of February 2022. The checklist was used to audit the presence or absent of the following variables; patient name, sex, age, telephone contact of patient and requesting clinician, patients\u0026rsquo; hospital number, patient residence, destination (clinicians\u0026rsquo; location), name of doctor, type of specimen, time and date of collection, investigation required, clinical history and provisional diagnosis in LRFs. Data was collected and analyzed using in Epi Info 7 where descriptive statistics were calculated.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eOut of 272 sampled LRFs, none contained complete information for all required parameters. Patient name and requested test fields were fully and accurately completed for all patients. Patient age, gender, and the name of the requesting clinician were provided and accurately recorded on over 98% of the LRFs. However, there was a notable deficiency in recording the time of specimen collection, with percentages of 0.0%, for patient and clinician telephone contacts, 0.74%, and 1.47%, respectively.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eClinicians may lack awareness of the significance of completing LRFs adequately. Therefore, regular orientation programs should be implemented to enhance the effectiveness of LRFs completion.\u003c/p\u003e","manuscriptTitle":"Evaluation of Laboratory Request Form Variables as Filled by Clinicians at Msambweni County Referral Hospital, Kwale County, Kenya. 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