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循证实践:临床医生在医院中对床边检测的使用及态度

Evidence based practice: clinicians' use and attitudes to near patient testing in hospitals.

作者信息

Gray T A, Freedman D B, Burnett D, Szczepura A, Price C P

机构信息

Department of Clinical Chemistry, Northern General Hospital, Sheffield.

出版信息

J Clin Pathol. 1996 Nov;49(11):903-8. doi: 10.1136/jcp.49.11.903.

Abstract

AIM

To survey the use made of laboratory services for urgent tests and clinicians' attitudes to near patient testing.

METHODS

A questionnaire was sent to clinicians working in acute hospitals within Trent and North West Thames Regions.

RESULTS

197 replies were received. Most demand came from intensive care units. Overall, clinicians requested a median of six urgent tests a day. Blood glucose and dip stick urine testing were the most commonly performed bedside tests, but 41% of clinicians did not use ward testing. The most frequently cited indication for bedside testing was the need for speed. 85% of clinicians trusted results obtained in their central hospital laboratory, but there was an almost equal division between those who did (34%) and those who did not (38%) trust the results from near patient testing. A slightly larger proportion indicated they would accept responsibility (44%) for results obtained on the ward than would not (35%). Most staff indicated that better transport to the laboratory would remove the need for near patient testing.

CONCLUSIONS

Clinicians have demonstrated an apparent need for rapid response testing but there is a strong preference for rapid transport systems and central laboratory analysis rather than bedside testing as a solution to this problem. There is a need to investigate the clinical and cost-effectiveness of near patient testing as a solution to rapid response testing.

摘要

目的

调查急诊检验中实验室服务的使用情况以及临床医生对患者床边检测的态度。

方法

向特伦特和泰晤士河北部地区急症医院的临床医生发放问卷。

结果

共收到197份回复。大部分需求来自重症监护病房。总体而言,临床医生每天要求进行的急诊检验中位数为6次。血糖和尿试纸检测是最常进行的床边检测项目,但41%的临床医生不使用病房检测。床边检测最常被提及的理由是需要快速得出结果。85%的临床医生信任中心医院实验室的检测结果,但信任患者床边检测结果的临床医生占比(34%)与不信任的占比(38%)几乎相同。表示会对病房检测结果负责的工作人员比例(44%)略高于不会负责的比例(35%)。大多数工作人员表示,改善送往实验室的运输条件将消除对患者床边检测的需求。

结论

临床医生已表明对快速反应检测有明显需求,但他们强烈倾向于快速运输系统和中心实验室分析,而非将床边检测作为解决该问题的方法。有必要调查患者床边检测作为快速反应检测解决方案的临床效果和成本效益。

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Near-patient testing: the management issues.
Health Serv Manage. 1994 Mar;90(3):10-1, 13.
2
The patient-focused hospital.以患者为中心的医院。
Healthc Forum J. 1991 Jul-Aug;34(4):16-9, 21.
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Clinical biochemistry nearer the patient.临床生物化学更贴近患者。
Br Med J (Clin Res Ed). 1983 Apr 9;286(6372):1166-7. doi: 10.1136/bmj.286.6372.1166.
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