Davids Ameerah, Zemlin Annalise E, Kruger Elsie C
Department of Pathology, Division of Chemical Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Department of Pathology, Division of Chemical Pathology, National Health Laboratory Service, Cape Town, South Africa.
Afr J Lab Med. 2024 Sep 23;13(1):2457. doi: 10.4102/ajlm.v13i1.2457. eCollection 2024.
Critical laboratory results are test results suggesting a patient is in immediate danger unless treatment is administered promptly. There is a paucity of studies in sub-Saharan Africa on clinicians' utility of these results and affected patients' outcomes. In our resource-limited setting in South Africa, we rely on telephonic communication to convey critical results.
The aim of this study was to determine the average time for clinicians to acknowledge these results on the laboratory information system and to determine the outcome of affected patients.
A retrospective descriptive audit at Tygerberg Academic Hospital was conducted between 01 October 2021 and 31 March 2022. Critical results and the time of acknowledgement by clinicians on the laboratory information system were obtained from inpatients and outpatients. One hundred and twenty inpatient critical results were randomly selected for a folder review to determine patient outcome.
Overall, 2514 critical results were reported, and 63 results were excluded. The remaining 2451 results were obtained from 1346 patients. The majority (94.5%) of results were obtained from inpatients, where 1681 (68.6%) were acknowledged within 24 h. The folder audit of 120 patients determined that 40 (33.3%) patients demised. In 82 (68.3%) patients, communication of a critical result did not alter clinical management.
Critical laboratory results are crucial to patient care. This study found that approximately one-third of critical laboratory results were not used within 24 h. Engaging clinicians in current practice and implementing a means of improved communication of critical results is required.
The study adds to the evidence of challenges experienced with communicating critical results to clinicians which could impact patient care. This is especially true in resource-limited settings; clinicians need to be made aware of the importance of these results, and communication modes need to be improved.
危急检验结果是指那些表明患者处于紧急危险状态，除非立即进行治疗的检验结果。撒哈拉以南非洲地区针对临床医生对这些结果的利用情况以及受影响患者的预后开展的研究较少。在南非资源有限的环境中，我们依靠电话沟通来传达危急结果。
本研究的目的是确定临床医生在实验室信息系统上确认这些结果的平均时间，并确定受影响患者的预后。
于2021年10月1日至2022年3月31日在泰格伯格学术医院进行了一项回顾性描述性审计。从住院患者和门诊患者中获取危急结果以及临床医生在实验室信息系统上的确认时间。随机选择120例住院患者的危急结果进行病历审查，以确定患者的预后。
总体而言，共报告了2514例危急结果，排除63例。其余2451例结果来自1346名患者。大多数（94.5%）结果来自住院患者，其中1681例（68.6%）在24小时内得到确认。对120例患者的病历审查确定，40例（33.3%）患者死亡。在82例（68.3%）患者中，危急结果的传达并未改变临床管理。
危急检验结果对患者护理至关重要。本研究发现，约三分之一的危急检验结果在24小时内未得到利用。需要让临床医生参与当前的实践，并实施一种改进危急结果沟通的方法。
该研究补充了有关向临床医生传达危急结果时所面临挑战的证据，这些挑战可能会影响患者护理。在资源有限的环境中尤其如此；需要让临床医生意识到这些结果的重要性，并改进沟通方式。
