[1]费阳,王薇,王治国.临床检验危急结果报告的规范化[J].现代检验医学杂志,2015,30(06):1-5.[doi:10.3969/j.issn.1671-7414.2015.06.001]
 FEI Yang,WANG Wei,WANG Zhi-guo.Normalization of Critical Result Reporting in Laboratory Medicine[J].Journal of Modern Laboratory Medicine,2015,30(06):1-5.[doi:10.3969/j.issn.1671-7414.2015.06.001]
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临床检验危急结果报告的规范化()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第30卷
期数:
2015年06期
页码:
1-5
栏目:
述评
出版日期:
2015-12-30

文章信息/Info

Title:
Normalization of Critical Result Reporting in Laboratory Medicine
作者:
费阳王薇王治国
北京医院卫生部临床检验中心,北京100730
Author(s):
FEI YangWANG WeiWANG Zhi-guo
National Center for Clinical Laboratories, Beijing Hospital,Beijing 100730,China
关键词:
危急结果医学检验患者安全
分类号:
R446
DOI:
10.3969/j.issn.1671-7414.2015.06.001
文献标志码:
A
摘要:
危急结果可能意味着一个危及生命或者可能导致有意义的患者发病或不可逆损害或死亡并因此需要紧急的医疗关注和行动的病理生理状态。因此,危急结果的及时和准确报告对患者安全极其重要。国际认可和患者安全标准要求医学实验室拥有用于及时可靠的将危急结果报告给负责患者的医护人员的系统。许多文献中描述了各种各样的危急结果报告实践和技术。然而,全国性调查显示出了现存危急结果报告的缺点和不足。以这些文献为基础,该文对各种报告实践进行了总结。希望能提出一致性术语,同时提供一个设计更好和更循证的能及时通知可能危害患者安全的实验室结果的方法。
Abstract:
Critical result was a test result which may signify a pathophysiologic state that is potentially life threatening or that could result in significant patient morbidity or irreversible harm or mortality and therefore requires urgent medical attention and action.Thus the timeliness and accuracy of critical results reporting is really important for patient safety.International accreditation and patient safety standards require pathology laboratories to have a system for the timely and reliable communication of alert results to clinical personnel responsible for patient care.Various practices and a number of different terminologies of critical results reporting have been described in the literature.However,multinational surveys highlighted shortcomings and inefficiencies in existing communication systems.Based on these literatures,several reporting practices were summarized in this article,hoping to provide harmonized terms as well as more evidence-based systems for the timely notification of laboratory results.

参考文献/References:

[1]Walz SE,Darcy TP.Patient safety and post-analytical error[J].Clin Lab Med,2013,33(1):183-194.
[2]Lundberg GD.When to panic over abnormal values[J].Med Lab Obs,1972(4):47-54.
[3]International Organization for Standardization.Medical laboratories-requirements for quality and competence[S].Switzerland:Geneva ISO15189,2012.
[4]The Joint Commission’s.2011 National Patient Safety Goals,Laboratory Accreditation Program[OL].http://www.jointcommission.org/assets/1/18/NPSG_Chapter_Jan2013_LAB.pdf(last accessed 1 September 2013).
[5]College of American Pathologists.Commission on Laboratory Accreditation,Laboratory Accreditation Program.Laboratory general checklist-questions related to reporting of results only[OL].GEN.41320-41340 http://www.cap.org/apps/docs/pathology_reporting/LabGeneralChecklist_Reporting.pdf;2005.last accessed 1September 2013.
[6]Clinical Pathology Accreditation Standards for Medical Laboratories[OL].Ltd,UK;Version2.02;November 2010.http://www.cpa-uk.co.uk/files/PD-LAB-Standards_v2.02_Nov_2010.pdf (last accessed 1 September 2013).
[7]Singh H,Vij MS.Eight recommendations for policies for communicating abnormal test results[J].Jt Comm J Qual Patient Saf,2010,36(5):226-232.
[8]Howanitz PJ,Steindel SJ,Heard NV.Laboratory critical values policies and procedures:a college of American pathologists Q-probes study in 623 institutions[J].Arch Pathol Lab Med,2002,126(6):663-669.
[9]Lippi G,Banfi G,Buttarello M,et al.Recommendations for detection and management of unsaitable samples in clinical laboratories[J].2007,45(6):728-736.
[10]Piva E,Sciacovelli L,Laposata M,et al.Assessment of critical values policies in Italian institutions:comparison with the US situation[J].Clin Chem Lab Med,2010,48(4):461-468.
[11]Campbell C,Horvath A.Towards harmonisation of critical laboratory result management-review of the literature and survey of Australasian practices[J].Clin Biochem Rev,2012,33(4):149-160.
[12]Maria Antonia Llopis Diaz,Ruben Gomez Rioja,Virtudes Alvarez Funes,et al.Critical values reporting:Results of a Spanish laboratories survey[J].Revista del Laboratorio Clinico,2010,3(4):177-182.
[13]Zeng R,Wang W,Wang Z.National survey on critical values notification of 599 institutions in China[J].Clin Chem Lab Med,2013,50(11):2099-2107.
[14]Don-Wauchope AC,Chetty VT.Laboratory defined critical value limits:how do hospital physicians perceive laboratory based critical values?[J].Clin Biochem,2009,42(9):766-770.
[15]Valenstein P.Critical communication[J].Clin Chem,2010,56(3):334-335.
[16]Barron J,Ng C,Aspin L,et al.Reflex testing to define action limits for community-based requests[J].Ann Clin Biochem,2012,49(Pt 4):337-340.
[17]Genzen JR,Tormey CA.Education Committee of the Academy of Clinical Laboratory Physicians and Scientists.Pathology consultation on reporting of critical values[J].Am J Clin Pathol,2011,135(4):505-513.
[18]Tillman J,Barth JH,ACB National Audit Gruup.A survey of laboratory ‘critical (alert) limits’ in the UK[J].Ann Clin Biochem,2003,40(Pt2):181-184.
[19]Wagar EA,Friedberg RC,Souers R,et al.Critical values comparison:a College of American Pathologists Q-Probes Survey of 163 clinical laboratories[J].Arch Pathol Lab Med,2007,131(12):1769-1775.
[20]Sirisali K,Manochiopinij S,Leelahakul P,et al.Critical value of the clinical laboratory test in Thailand[J].J Med Assoc Thai,2010,93(Suppl6):S22-27.
[21]Kost GJ.Using critical limits to improve patient outcome[J].MLO Med Lab Obs,1993,25(3):22-27.
[22]Chakraborty S,Bhattacharya C,Das S,et al.Delta check:a must in the management of hyponatremia[J].Clin Chem Lab Med,2013,51(7):E161-E162.
[23]The Joint Commission.Standards FAQ details-critical tests,results and values NPSG.Goal 2. 02.03.01:chronically critical values and repeatedly critical values[OL].Revised November 24,2008.http://www.jointcommission.org/mobile/standards_information/jcfaqdetails.aspx?StandardsFAQId=394&StandardsFAQChapterId=77[last accessed on 1 September 2013].
[24]Yang D,Zhou Y,Yang C.Analysis of laboratory repeat critical values at a large tertiary teaching hospital in China[J].PLoS One,2013,8(3):e59518.
[25]Toll AD,Liu JM,Gulati G,et al.Does routine repeat testing of critical values offer any advantage over single testing?[J].Arch Pathol Lab Med,2011,135(4):440-444.
[26]Hanna D,Griswold P,Leape LL,et al.Communicating critical test results:safe practice recommendations[J].Jt Comm J Qual Patient Saf,2005,31(2):68-80.
[27]Piva E,Sciacovelli L,Zaninotto M,et al.Evaluation of effectiveness of a computerized notification system for reporting critical values[J].Am J Clin Pathol,2009,131(3):432-441.
[28]Parl FF,O’Leary MF,Kaiser AB,et al.Implementation of a closed-loop reporting system for critical values and clinical communication in compliance with goals of the joint commission[J].Clin Chem,2010,56(3):417-423.
[29]Dighe AS,Jones JB,Parham S,et al.Survey of critical value reporting and reduction of false-positive critical value results[J].Arch Pathol Lab Med,2008,132(10):1666-1671.
[30]Sikaris K.Application of the Stockholm hierarchy to defining the quality of reference intervals and clinical decision limits[J].Clin Biochem Rev,2012,33(4):141-148.

备注/Memo

备注/Memo:
基金项目:北京市自然科学基金资助项目(基金编号:71431821),北京医院资助课题(BJ-2015-025)。 作者简介:费阳(1991-),女,在读硕士研究生,研究方向:实验室质量管理,E-mail:dancesherlocked@163.com。 通讯作者:王治国,硕士,研究员,主要从事临床检验质量控制方法研究和室间质量评价工作,E-mail:zgwang@nccl.org.cn。
更新日期/Last Update: 1900-01-01