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潜在的医疗错误:甲状腺功能检测申请单填写不完整,限制了病理学家为临床医生提供建议。

Potential for medical error: incorrectly completed request forms for thyroid function tests limit pathologists' advice to clinicians.

机构信息

Division of Chemical Pathology, National Health Laboratory Service, Tygerberg Hospital, Stellenbosch University, Tygerberg, W Cape.

出版信息

S Afr Med J. 2009 Sep;99(9):668-71.

Abstract

BACKGROUND

Various publications have highlighted the significance of laboratory errors in the pre- and post-analytical phases and their impact on results. Thyroid-stimulating hormone (TSH) is a first-line thyroid function test and, if abnormal, reflex thyroxine (T4) or tri-iodothyronine (T3) testing is requested, depending on clinical and medication data provided. Interpretative comments are added to all TFT results.

OBJECTIVES

In view of the paucity of articles describing such errors, we audited laboratory request forms requesting thyroid function tests (TFT), received from primary care clinics and regional hospitals at our laboratory.

DESIGN

We assessed 482 laboratory request forms for TFT from primary health care clinics for specific parameters.

RESULTS

A total of 482 forms were analysed. Medication/s used by the patient (74.5%) and doctor's contact number (65.1%) were the most commonly incomplete parameters. Of the 123 patients with medication details, 62 (50.4%) were on thyroxine.

CONCLUSIONS

There are few studies examining the frequency and impact of incomplete laboratory forms on laboratory errors, and even fewer studies examining interpretative comments accompanying clinical biochemistry results. We studied how pre-analytical errors in completing request forms may lead to incorrect interpretative comments and inappropriate reflex testing, and so influence the quality of the post-analytical phase.

摘要

背景

许多出版物都强调了实验室在分析前和分析后阶段的错误的重要性,以及这些错误对结果的影响。促甲状腺激素(TSH)是甲状腺功能的一线检测,如果异常,根据提供的临床和用药数据,会要求进行甲状腺素(T4)或三碘甲状腺原氨酸(T3)的反射检测。所有甲状腺功能全项(TFT)结果都会添加解释性注释。

目的

鉴于描述此类错误的文章很少,我们对从我们实验室所在的初级保健诊所和地区医院收到的甲状腺功能检测(TFT)实验室申请表格进行了审核。

设计

我们评估了来自初级保健诊所的 482 份 TFT 实验室申请表格,以评估特定参数。

结果

共分析了 482 份表格。患者用药情况(74.5%)和医生联系号码(65.1%)是最常见的不完整参数。在有用药细节的 123 名患者中,有 62 名(50.4%)正在服用甲状腺素。

结论

很少有研究检查不完整实验室表格对实验室错误的频率和影响,更少有研究检查伴随临床生化结果的解释性注释。我们研究了在填写申请表格时的分析前错误如何导致不正确的解释性注释和不适当的反射检测,从而影响分析后阶段的质量。

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