Quality and Accreditation Directorate, Ministry of Health, Kuwait City, Kuwait.
Assistant Undersecretary of Public Health Affairs, Ministry of Health, Kuwait City, Kuwait.
BMC Health Serv Res. 2022 Aug 3;22(1):986. doi: 10.1186/s12913-022-08329-z.
Notification of laboratory-determined critical values is key for effective clinical decision making and is thus a consequential step in a patient's health care and safety. This study presents an overview of staff reporting policies and procedures concerning critical values in Kuwaiti governmental hospitals.
A cross-sectional descriptive study design was adopted. Study subjects were affiliated with laboratories from five government hospitals (four general and one sub-specialty hospital). All laboratory staff in every hospital were included. The Statistical Package for the Social Sciences (version 23) was used to analyse the collected data at a significance level of ≤ 0.05. Quantitative data analysis included univariate descriptive (means, medians, standard deviations, frequencies, percentages) and bivariate (chi-squared, ANOVA and Kruskal-Wallis tests) analyses. These analyses provided associations between participating hospitals and staff perceptions towards the policies and procedures surrounding critical values.
559 questionnaires were returned, a total response of 30.5% after those of 79 phlebotomists were excluded (eligible sample size n = 1833). The notification of critical values differs between participated laboratories in delivering protocol and time duration. Linked protocols between laboratories did not exist regarding policies and guidelines for applying the same procedures for critical value notification. There are differences in critical value limits among the participating laboratories.
This study is the first to survey laboratory staff perceptions of critical value practices in Kuwaiti government hospitals. Enhancing critical value reporting and policy is crucial for improving patient safety and to develop high-quality health services. The findings of this study can help policy makers implement future intervention studies to enhance laboratory practices in the area of critical values and improve patient safety and the quality of government hospital systems.
实验室确定的危急值通知对于有效的临床决策至关重要，因此是患者医疗保健和安全的重要环节。本研究概述了科威特政府医院中与危急值相关的员工报告政策和程序。
采用横断面描述性研究设计。研究对象与来自五家政府医院（四家综合医院和一家专科医院）的实验室有关。每家医院的所有实验室工作人员都包括在内。使用社会科学统计软件包（第 23 版）在≤0.05 的显著水平下分析收集的数据。定量数据分析包括单变量描述性分析（均值、中位数、标准差、频率、百分比）和双变量分析（卡方检验、方差分析和克鲁斯卡尔-沃利斯检验）。这些分析提供了参与医院与工作人员对危急值相关政策和程序的看法之间的关联。
共收回 559 份问卷，剔除 79 名采血员（合格样本量 n=1833）后，总应答率为 30.5%。危急值的通知在不同参与实验室之间在传递方案和时间持续时间方面存在差异。关于应用相同危急值通知程序的政策和指南，实验室之间没有链接协议。参与实验室的危急值限值存在差异。
这是首次调查科威特政府医院实验室工作人员对危急值实践的看法。加强危急值报告和政策对于提高患者安全性和发展高质量卫生服务至关重要。本研究的结果可以帮助决策者实施未来的干预研究，以加强危急值领域的实验室实践，提高患者安全性和政府医院系统的质量。
