某三级医院生化实验室关键结果通报方案的有效性评价

IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL Journal of Laboratory Physicians Pub Date : 2023-09-27 DOI:10.1055/s-0043-1775573
Silpa Thota, Aparna R. Bitla
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引用次数: 0

摘要

关键值报告是检验医学的一个重要方面,确保及时沟通危及生命的结果给临床医生立即采取行动。现有的指导方针强调及时通报的重要性,但方案可能有所不同。本研究评估了三级医院生物化学实验室报告关键结果的方案的有效性,并提出了改进的替代方案。资料与方法收集6个月的调查总数、检测到的临界值、分析的参数、涉及的临床科室。评估质量指标,如周转时间(TAT)、不成功报告率和所采取的临床措施。采用Microsoft Excel进行统计分析。结果39万份调查中,0.5%有临界值。血清钾(55.9%)出现临界值的频率最高,其次是钠、钙和葡萄糖。急诊科收到的紧急警报数量最多。1小时内关键结果报告成功率为86.8%,报告不成功率为10.7%。不成功的报告的原因包括门诊请求和延迟通知由于病人转移。91%的病例采取了纠正措施,主要记录在护士图表中。结论:对报告关键结果的方案进行评估,确定了需要改进的领域。建议包括修订关键价值清单,通过流程优化和自动化来减少TAT,加强员工培训和意识,促进跨学科合作,以及维护事件记录。实施这些更改可以增强遵从性、减少错误并改善患者护理。
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Evaluation of the Effectiveness of Critical Result Notification Protocol of Biochemistry Laboratory at a Tertiary Care Hospital
Abstract Background Critical value reporting is an essential aspect of laboratory medicine, ensuring prompt communication of life-threatening results to clinicians for immediate action. Existing guidelines emphasize the importance of timely notification, but protocols may vary. This study evaluated the effectiveness of the protocol for reporting critical results in the biochemistry laboratory of a tertiary care hospital and proposed alternative protocols for improvement. Materials and Methods Data were collected over a 6-month period, including the total number of investigations, critical values detected, parameters analyzed, and clinical departments involved. Quality indicators such as turnaround time (TAT), unsuccessful reporting rates, and clinical actions taken were assessed. Statistical analysis was performed using Microsoft Excel. Results Out of 390,000 investigations, 0.5% had critical values. Serum potassium (55.9%) had the highest frequency of critical values, followed by sodium, calcium, and glucose. The emergency department received the highest number of critical alerts. The success rate of critical result reporting within 1 hour was 86.8%, while unsuccessful reporting accounted for 10.7%. The causes of unsuccessful reporting included outpatient requests and delayed intimation due to patient transfers. Corrective action was taken in 91% of cases, with documentation primarily in nurse charts. Conclusion Evaluation of the protocol for reporting critical results identified areas for improvement. Recommendations included revising the critical value list, reducing TAT through process optimization and automation, enhancing staff training and awareness, fostering interdisciplinary collaboration, and maintaining incident records. Implementing these changes can enhance compliance, reduce errors, and improve patient care.
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来源期刊
Journal of Laboratory Physicians
Journal of Laboratory Physicians MEDICINE, GENERAL & INTERNAL-
自引率
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发文量
99
审稿时长
31 weeks
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