Howanitz P J, Steindel S J
Department of Pathology, UCLA Medical Center 90024-1713.
Arch Pathol Lab Med. 1991 Oct;115(10):977-83.
More than 400 laboratories participated in the module of the College of American Pathologists' quality assurance program, Q-Probes, which measured intralaboratory turnaround time (TAT) of stat cerebrospinal fluid tests. Four determinations encompassing more than 14,000 specimens were monitored and intralaboratory TATs were compared with participants' TAT goals. The median TATs were as follows: cell count, 32 minutes; glucose, 34 minutes; protein, 37 minutes; and Gram's stain, 45 minutes. Between 14% and 21% of participants (test dependent) met their goals 100% of the time, with 72% of the determinations completed within the time laboratorians required. Standard statistical stepwise regression analysis was used to model influence of up to eight factors on TAT. Correlations were test and bed-size dependent, but ranged from a high of .23 to a low of .02. Only computerized reporting and instrumentation measuring protein and glucose had a consistent effect, delaying TAT, whereas use of a stat laboratory, one workstation, automation, computerized order entry, and centralized processing gave variable results. We conclude that laboratorian goals for cerebrospinal fluid test TAT are met most of the time, and that a stepwise regression analysis poorly explains factors that statistically influence TAT.
400多个实验室参与了美国病理学家学会质量保证计划Q-Probes的模块,该模块测量了急诊脑脊液检测的实验室内部周转时间(TAT)。对涵盖14000多个样本的四项测定进行了监测,并将实验室内部周转时间与参与者的周转时间目标进行了比较。中位数周转时间如下:细胞计数为32分钟;葡萄糖为34分钟;蛋白质为37分钟;革兰氏染色为45分钟。14%至21%的参与者(取决于检测项目)100%的时间达到了他们的目标,72%的测定在实验室工作人员要求的时间内完成。使用标准统计逐步回归分析对多达八个因素对周转时间的影响进行建模。相关性取决于检测项目和床位数量,但范围从高的0.23到低的0.02。只有计算机化报告以及测量蛋白质和葡萄糖的仪器有一致的影响,会延迟周转时间,而使用急诊实验室、一个工作站、自动化、计算机化医嘱录入和集中处理则产生了不同的结果。我们得出结论,实验室工作人员设定的脑脊液检测周转时间目标大多时候都能实现,而且逐步回归分析很难解释对周转时间有统计学影响的因素。