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减少基层医疗样本分析前错误的多学科培训活动。

Multidisciplinary training activities for decreasing preanalytical mistakes in samples from primary care.

作者信息

Romero Adolfo, Gómez-Salgado Juan, Gómez-Fernández José Antonio, Cobos Andrés, Ruiz-Frutos Carlos

机构信息

.

出版信息

Clin Chem Lab Med. 2017 Oct 26;55(11):1715-1721. doi: 10.1515/cclm-2016-1002.

Abstract

BACKGROUND

The presence of preanalytical mistakes (PM) in samples from primary care centres (PCC) is a widely studied topic. Different correcting strategies have been proposed, with variable success. We planned a series of multidisciplinary sessions for clinical update, with the aim to decrease PM rates in samples from PCC.

METHODS

The incidence of PM in samples from PCC processed at the laboratories of University Hospital Virgen de la Victoria (LAB1) and University Hospital Juan Ramon Jimenez (LAB2) was assessed during two time periods (October to November 2013 and January to May 2014). Clinical update sessions were conducted between periods (2014). Differences in PM rates between observation periods were evaluated.

RESULTS

With respect to 2014, we observed a significant reduction of PM rates in blood samples processed at LAB1 during 2015, whereas those in LAB2 were slightly increased. The most common PMs were haemolysed sample at LAB1 and missed sample at LAB2.

CONCLUSIONS

Although the presence of PM remains slightly high, there was a significant reduction after the clinical update sessions in LAB1, where the most frequent PM was haemolysed sample. In contrast, the PM rates were slightly increased at LAB2, and the main source was missed sample. This might be explained, at least in part, by different problems associated with sample transportation, and by the delay in transferring acquired knowledge into clinical practice. Implementation of regular programme of update sessions and improvements in sample transportation might help to reduce the PM presence in our area.

摘要

背景

基层医疗中心(PCC)样本中存在的分析前错误(PM)是一个被广泛研究的课题。已经提出了不同的纠正策略,但成效各异。我们计划开展一系列多学科临床更新会议,旨在降低PCC样本中的PM发生率。

方法

在两个时间段(2013年10月至11月和2014年1月至5月)评估了在维多利亚圣母大学医院实验室(LAB1)和胡安·拉蒙·希门尼斯大学医院实验室(LAB2)处理的PCC样本中的PM发生率。在两个时间段之间(2014年)召开了临床更新会议。评估了观察期之间PM发生率的差异。

结果

与2014年相比,我们观察到2015年LAB1处理的血液样本中PM发生率显著降低,而LAB2的PM发生率略有增加。最常见的PM在LAB1是溶血样本,在LAB2是漏检样本。

结论

尽管PM的发生率仍然略高,但在LAB1进行临床更新会议后有显著降低,其中最常见的PM是溶血样本。相比之下,LAB2的PM发生率略有增加,主要来源是漏检样本。这至少部分可以通过与样本运输相关的不同问题以及将获得的知识转化为临床实践的延迟来解释。实施定期更新会议计划和改善样本运输可能有助于减少我们地区PM的存在。

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