医学实验室的关键结果。管理与沟通

H. Maksymyuk, O. Yastremska, Andriy Kost, Natalija Boykiv
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引用次数: 0

摘要

医学界越来越重视精简明确的机制,以报告诊所的关键检测结果。DSTU ISO 15189: 2015要求实验室在规定的时间内向临床医生报告关键的测试结果。此外,它们应该有一个明确确立的程序。为了使流程标准化,避免利益相关者之间的误解,国际组织(RCPA、AACB、CLSI)制定了数据文档的术语、通信算法和要求。为了协调这一部分,已经进行了大量的调查,哪些分析物应该包括在通报表中,特别是血液学,止血学和生化研究的值的限制。根据ICSH的建议,关键风险结果包括血红蛋白、白细胞、中性粒细胞、血小板、活化的部分凝血活素时间(aPTT)、凝血酶原时间(PT) /国际正常化比率(INR)和纤维蛋白原。这些实验室在警报清单中包括了不同的生化测试。最常见的分析物是葡萄糖、钾、钠和钙。需要注意的是,本警报清单仅建议用于临床实验室,如指标的数量和分析物的警报阈值应与特定医疗机构的临床医生商定,考虑到他们的经验和当地患者人口。制定的建议将使我们能够尽快对可能威胁患者生命的情况作出反应,及时提供合格的医疗服务,并根据国际标准的要求调整工作程序。
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Critical results in medical laboratory. management and communication
The medical community is gaining increased attention to streamlining a clear mechanism for reporting critical test results in the clinic. DSTU ISO 15189: 2015 requires laboratories to report critical test results to clinitians within a specified period of time. Moreover, they should have a clearly established procedure in place. In order to standardize processes and avoid misunderstandings between stakeholders, international organizations (RCPA, AACB, CLSI) have developed terminology, communication algorithm and requirements for data documentation. In order to harmonize this part, a lot of surveys have been conducted as to which analytes should be included in the notification sheet and, in particular, the limits of their values for hematological, hemostasiological and biochemical studies. According to ICSH recommendations, critical risk results include hemoglobin, leukocytes, neutrophils, platelets, activated partial thromboplastin time (aPTT), prothrombin time (PT) / international normalization ratio (INR) and fibrinogen. The laboratories include different biochemical tests in the alert list. The most common analytes are glucose, potassium, sodium and calcium. It should be noted that this alert list is only recommended for clinical laboratories, such as the number of indicators and alert threshold of analytes should be agreed with the clinicians of a particular medical institution, taking into account their experience and local patient population. The developed recommendations will allow to react as quickly as possible to situations that may threaten patient’s life, provide qualified medical care in a timely manner and adjust work processes in accordance with the requirements of international standards.
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