Neonatal bilirubin testing practices: reports from 312 laboratories enrolled in the Colege of American Pathologists Excel Proficiency Testing Program.

OBJECTIVE

To characterize laboratory practices for neonatal bilirubin testing and to identify opportunities for improvement.

DESIGN

A voluntary self-assessment questionnaire was used to assess the laboratory practices of 312 laboratories subscribing to the College of American Pathologists (CAP) Excel Chemistry Proficiency Testing Program.

RESULTS

A range of preanalytic and analytic practices were reported. The most notable problems identified were the use of overly long capillary puncture devices (17.8%), failure to protect the specimen from light prior to analysis (3.4%), failure to use a control containing >171 micromol/L bilirubin (26.1%), use of single-level control (4.2%), and lack of established linearity limits (7.0%).

CONCLUSION

Opportunities exist to improve specimen collection, processing, and analysis for some physician-office and small-hospital laboratories.