中国一家教学医院血液学成人危急结果政策评估
An evaluation of adult critical result policies in haematology in a teaching hospital in China.
作者信息
Yang Dagan, Cai Qian, Qi Xinglun, Xu Lili, Zhou Yunxian
机构信息
Department of Laboratory Medicine, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.
School of Nursing, Zhejiang Chinese Medical University, Hangzhou 310053, China.
出版信息
Ann Transl Med. 2019 Feb;7(3):47. doi: 10.21037/atm.2019.01.16.
BACKGROUND
Critical result (CR) reporting is one of the core policies in China, yet it varies in different hospitals. In addition, few reports of the evaluation of CR policies have been published. This study aimed to evaluate the adult CR policies for haematology in a teaching hospital.
METHODS
The consistency was compared between CR policies in a tertiary hospital in China and the current standards, consensuses and literature. The incidences for the alert thresholds of white blood cells (WBC), haemoglobin (HgB), and platelets (PLT) and the turn-around time (TAT) for different phases of CR reporting in 2017 were investigated. On-site observation of the staff was used to assess CR implementation and compliance with CR policies.
RESULTS
The clauses of adult CR policies in haematology were consistent with the requirements in the standards, consensuses and literature, and the CR items and alert thresholds were within the range reported in the literature. CRs in haematology were dominated by lower thresholds. The incidences of alerts due to WBC, HgB, and PLT levels were 37.5, 18.0 and 37.0 times/day, respectively. A total of 150 cases of CR implementation were observed on-site, and the procedures followed by the staff were consistent with the requirements of the polices. The TAT medians for CR verification in the outpatient, emergency and inpatient departments were ≤6 min.
CONCLUSIONS
The consistency and implementation of CR policies were both good, which ensures patient safety.
背景
危急值报告是我国的核心政策之一，但不同医院的情况有所不同。此外，关于危急值政策评估的报道很少。本研究旨在评估一家教学医院的成人血液学危急值政策。
方法
比较中国一家三级医院的危急值政策与现行标准、共识和文献之间的一致性。调查了2017年白细胞（WBC）、血红蛋白（HgB）和血小板（PLT）警报阈值的发生率以及危急值报告不同阶段的周转时间（TAT）。通过对工作人员的现场观察来评估危急值的实施情况和对危急值政策的遵守情况。
结果
成人血液学危急值政策的条款与标准、共识和文献中的要求一致，危急值项目和警报阈值在文献报道的范围内。血液学危急值以较低阈值为主。因白细胞、血红蛋白和血小板水平发出警报的发生率分别为每天37.5次、18.0次和37.0次。共现场观察了150例危急值实施情况，工作人员遵循的程序与政策要求一致。门诊、急诊和住院部危急值核查的TAT中位数均≤6分钟。
结论
危急值政策的一致性和实施情况都很好，这确保了患者安全。
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