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一项基于问卷调查的研究,旨在评估三级护理医院医学院实习医生对实验室检测分析前阶段的了解情况。

Questionnaire-based Study to Assess Knowledge of Preanalytical Phase of Laboratory Testing Among Trainee Doctors in a Tertiary Care Hospital Medical College.

作者信息

Kulkarni Kalpana Ketan, Bhandari Anup Pravin, Unni Ashwin Keshavan

机构信息

Department of Pathology, BJ Govt. Medical College, Pune, Maharashtra, India.

出版信息

J Lab Physicians. 2020 Dec;12(3):178-183. doi: 10.1055/s-0040-1720945. Epub 2020 Nov 23.

Abstract

To determine the knowledge base of common laboratory practices related to preanalytical phase of laboratory testing among medical interns and first-year postgraduate residents in a tertiary care hospital medical college.  Questionnaire-based survey on preanalytical phase of laboratory testing was conducted among 208 participants, who volunteered and were MBBS interns and first-year postgraduate residents in a medical college, over the period from June 2018 to December 2019. A total of 15-item, multiple-choice questions (MCQs) were included, of which four were opinion-based and not considered for analysis. Responses were further categorized based on percentages with correct response, so we could identify specific knowledge points which need training.  Results were analyzed using Microsoft Excel functions and a simple calculator.  A total of 208 participants were included in the study, which consisted of an equal number of interns (104) and first-year postgraduate residents (104). The term "preanalytical error" was known to 62.5% of participants. Only 9.62% participants took formal training in phlebotomy. Topics related to questions like coagulation testing, ideal fasting duration, mixing of blood, and order of draw received less than 40% correct response which meant that it requires more training.  In this era of evidence-based medicine, central laboratory plays a pivotal role in patient management, and quality of laboratory results are of paramount importance. Over a period of time, automation technology has reduced analytical phase errors to the minimum. Most errors reported are part of the preanalytical phase, and it has been found that a majority of them are committed due to a lack of knowledge and skills. In order to improve the preanalytical phase and make it as error-free as possible, the staff (technicians, nurses, and trainee doctors) should be constantly motivated and trained.

摘要

确定一所三级护理医院医学院的医学实习生和一年级研究生住院医师在实验室检测分析前阶段相关常见实验室操作的知识基础。

在2018年6月至2019年12月期间,对一所医学院的208名自愿参与的医学学士实习生和一年级研究生住院医师进行了关于实验室检测分析前阶段的问卷调查。问卷共包含15道多项选择题,其中4道基于观点的题目未纳入分析。根据正确回答的百分比对回答进行进一步分类,以便我们能够确定需要培训的具体知识点。

使用微软Excel函数和简单计算器对结果进行分析。

共有208名参与者纳入研究,其中实习生(104名)和一年级研究生住院医师(104名)人数相等。62.5%的参与者知晓“分析前误差”这一术语。只有9.62%的参与者接受过静脉穿刺的正规培训。与凝血检测、理想禁食时长、血液混匀和采血顺序等问题相关的题目,正确回答率低于40%,这意味着需要更多培训。

在这个循证医学时代,中心实验室在患者管理中起着关键作用,实验室结果的质量至关重要。随着时间的推移,自动化技术已将分析阶段的误差降至最低。报告的大多数误差是分析前阶段的一部分,并且发现其中大部分是由于知识和技能不足造成的。为了改善分析前阶段并使其尽可能无差错应对,工作人员(技术人员、护士和实习医生)应不断得到激励和培训。

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本文引用的文献

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Pre-analytical workstations: a tool for reducing laboratory errors.分析前工作站:一种减少实验室误差的工具。
Clin Chim Acta. 2009 Jun;404(1):68-74. doi: 10.1016/j.cca.2009.03.024. Epub 2009 Mar 18.

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