Department of Laboratory Medicine, Hospital Universitari Son Espases, Palma, Spain.
Instituto de Investigación Sanitaria de las Islas Baleares, Spain.
Biochem Med (Zagreb). 2019 Oct 15;29(3):030703. doi: 10.11613/BM.2019.030703. Epub 2019 Aug 5.
Communication of laboratory critical risk results is essential for patient safety, as it allows early decision making. Our aims were: 1) to retrospectively evaluate the current protocol for telephone notification of critical risk results in terms of rates, efficiency and recipient satisfaction, 2) to assess their use in clinical decision making and 3) to suggest alternative tools for a better assessment of notification protocols.
The biochemical critical risk result notifications reported during 12 months by routine and STAT laboratories in a tertiary care hospital were reviewed. Total number of reports, time for the notification and main magnitudes with critical risk results were calculated. The use of notifications in clinical decision making was assessed by reviewing medical records. Satisfaction with the notification protocol was assessed through an online questionnaire to requesting physicians and nurses.
Critical result was yielded by 0.1% of total laboratory tests. Median time for notification was 3.2 min (STAT) and 16.9 min (routine). The magnitudes with a greater number of critical results were glucose and potassium for routine analyses, and troponin, sodium for STAT. Most notifications were not reflected in the medical records. Overall mean satisfaction with the protocol was 4.2/5.
The results obtained indicate that the current protocol is appropriate. Nevertheless, there are some limitations that hamper the evaluation of the impact on clinical decision making. Alternatives were proposed for a proper and precise evaluation.
实验室危急值结果的沟通对于患者安全至关重要，因为它可以促进早期决策。我们的目的是：1）回顾性评估当前电话通知危急值结果的协议在报告率、效率和接收者满意度方面的情况，2）评估其在临床决策中的应用，3）提出替代工具以更好地评估通知协议。
回顾了一家三级保健医院常规和 STAT 实验室在 12 个月内报告的生化危急值结果通知。计算了报告总数、通知时间和具有危急值结果的主要指标。通过查阅病历评估了通知在临床决策中的应用。通过向请求医生和护士的在线问卷评估了对通知协议的满意度。
危急值结果占总实验室检测的 0.1%。通知的中位数时间为 3.2 分钟（STAT）和 16.9 分钟（常规）。具有更多危急值结果的指标是常规分析中的葡萄糖和钾，以及 STAT 中的肌钙蛋白和钠。大多数通知并未反映在病历中。总体而言，对该协议的满意度平均为 4.2/5。
所获得的结果表明当前协议是合适的。然而，存在一些限制因素，阻碍了对其对临床决策影响的评估。提出了替代方案以进行适当和精确的评估。
