Sheppard Chelsea, Franks Nicole, Nolte Frederick, Fantz Corinne
Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA.
Am J Clin Pathol. 2008 Oct;130(4):573-7. doi: 10.1309/DGXYTH0VNTTQRQHD.
The purpose of our study was to improve the quality of care in an emergency department (ED) as measured by length of stay (LOS), total turnaround time (TAT) for laboratory result reporting, and the blood culture contamination rate. Data were included for patients who had at least 1 of 5 laboratory tests performed as part of their care. The study was conducted in 2 phases. First, phlebotomy was performed by a dedicated phlebotomist or nonlaboratory personnel. The second phase added a dedicated laboratory technologist. There was a significant reduction in total TAT for all tests (at least 46 and 75 minutes in the respective interventions), and blood culture contamination rates dropped from 5.0% to 1.1%, although the overall LOS did not change. Estimated cost avoidance is more than $400,000 annually. Quality of care in an ED is improved when samples are collected by a dedicated phlebotomist, but overall LOS does not change.
我们研究的目的是通过住院时间（LOS）、实验室结果报告的总周转时间（TAT）以及血培养污染率来提高急诊科（ED）的护理质量。纳入了在护理过程中至少进行了5项实验室检查中的1项的患者的数据。该研究分两个阶段进行。首先，由专门的采血员或非实验室人员进行静脉穿刺采血。第二阶段增加了一名专门的实验室技术人员。所有检查的总周转时间显著缩短（在各自的干预措施中分别至少缩短了46分钟和75分钟），血培养污染率从5.0%降至1.1%，尽管总体住院时间没有变化。估计每年避免的成本超过40万美元。当由专门的采血员采集样本时，急诊科的护理质量得到了改善，但总体住院时间没有变化。
