最適な実験室利用に向けて. プライマリケアにおける実験室検査の問題点
P A Nutting1, D S Main, P M Fischer
1Ambulatory Sentinel Practice Network, Denver, CO 80214, USA.
JAMA
|February 28, 1996
まとめ
検査検査の問題は,初等医療における1000回の診察のうち1.1回の割合で発生しています. これらの問題の4分の1以上,特に注文やサンプル処理に関する問題は,患者のケアに影響を及ぼしました.
科学分野:
- 臨床研究室科学科 臨床研究室科学科
- プライマリヘルスケア 医療の質 品質
- 患者の安全性についてです.
背景:
- 検査は,初等医療の意思決定に不可欠なものです.
- 実験室での検査の誤りを理解することは,患者の治療結果を改善するために極めて重要です.
- 以前の研究は,初等医療施設における検査問題の頻度と影響を完全に特徴づけることができませんでした.
研究 の 目的:
- プライマリケア医師の診療所で発生する検査問題の発生率と性質を決定する.
- これらの実験室検査の問題が患者の医療に与える影響を評価する.
主な方法:
- 6ヶ月間にわたって前向きで記述的な研究が行われました.
- 北米のプライマリケア臨床医は,構造化された機器を用いた実験室でのすべてのインシデントを報告した.
- Ambulatory Sentinel Practice Network (ASPN) の49の診療所の124人の臨床医からデータを収集した.
主要な成果:
- 合計で180件の実験室の問題が報告され,1000件の患者診察につき1.1件の問題が発生しました.
- 最も頻繁に見られる問題は,試験の注文と試料の取り扱い (56%) で,試験分析は13%を占めています.
- 診療スタッフは,問題の27%が患者のケアに影響を及ぼし,これらの影響の半分が重要であると判断しました.
結論:
- 臨床的に有意な検査の問題は,初等医療における患者訪問1000人当たり1.1人の割合で発生しています.
- これらの研究室の問題の有意な割合 (27%) は,臨床医によって患者のケアに影響すると見なされた.
- 検査の注文と試料の取り扱いを対象とした介入は,初等医療における検査エラーの削減に有益である可能性があります.
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