测量影响: 195项试验中的实验室错误造成的危害严重程度
Hikmet Can Çubukçu1, Murat Cihan2, Hamit Hakan Alp3
1Rare Diseases Department, General Directorate of Health Services, Turkish Ministry of Health, Ankara, Turkiye.
American journal of clinical pathology
|October 22, 2024
概括
医疗保健专家确定了实验室测试,这些实验室测试具有很高的错误患者伤害的潜力. 这项研究提供了客观的严重性评分,以指导对关键诊断试验的质量改进工作.
科学领域:
- 临床化学 临床化学
- 实验室医学 实验室医学
- 患者安全 患者安全
背景情况:
- 准确的实验室检测结果对于患者的诊断和治疗至关重要.
- 实验室测试中的错误可能会对患者造成重大伤害.
- 需要对实验室测试错误进行对危害严重性的系统评估.
研究的目的:
- 客观地评估来自195个实验室测试中的错误结果的潜在危害严重程度.
- 调查专业医生和医学生物化学专家,了解他们的风险感知.
- 为了确定实验室测试错误的客观严重性得分.
主要方法:
- 对514名专家 (75名医学生物化学家,439名临床医生) 进行了调查.
- 参与者对195个实验室测试的错误结果 (1-5级) 评价了危害的严重程度.
- 伤害评分与现有文献中识别的错误效应相匹配.
主要成果:
- 对心脏生物标志物,血液气体,凝血,关键离子,有毒元素和药物水平的测试被认为是高风险的.
- 医学生物化学家将更高的严重性得分分配给特定的测试,如总 bilirubin 和某些药物水平.
- 确定的高风险测试包括激活的局部血栓塑时间,前血时间,国际正常化比率和D-二次体.
结论:
- 临床医生和医学生物化学家在伤害严重程度得分上存在很高的共识 (91%).
- 实验室测试错误的客观严重性得分被确定.
- 这项研究确定了高风险的实验室试验,使得有针对性的质量改善举措成为可能.
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