实现最佳实验室使用. 在初级保健中实验室检测的问题
P A Nutting1, D S Main, P M Fischer
1Ambulatory Sentinel Practice Network, Denver, CO 80214, USA.
JAMA
|February 28, 1996
概括
实验室检测问题发生在每1000次初级保健访问中的1.1次. 超过四分之一的这些问题,特别是那些与订购和样本处理有关的问题,影响了患者的护理.
科学领域:
- 临床实验室科学 临床实验室科学
- 初级医疗保健 质量 质量 初级医疗保健
- 患者安全 患者安全
背景情况:
- 实验室检测是初级保健决策的组成部分.
- 了解实验室测试中的错误对于改善患者的治疗结果至关重要.
- 之前的研究还没有完全描述实验室检测问题的频率和影响在初级保健机构.
研究的目的:
- 确定在初级保健医生办公室遇到的实验室测试问题的发生率和性质.
- 评估这些实验室测试问题对患者医疗保健的影响.
主要方法:
- 一项前性,描述性研究在六个月内进行.
- 北美的初级保健医生报告了所有使用结构化仪器的实验室事件.
- 收集了124名临床医生的数据,这些数据来自ASPN (门诊哨兵实践网络) 的49个实践机构.
主要成果:
- 报告了总共180个实验室问题,相当于每1000次患者访问中有1.1个问题.
- 最常见的问题涉及测试订单和样品处理 (56%),测试分析占13%.
- 实践人员认为,27%的问题影响了患者的护理,其中一半的影响是显著的.
结论:
- 实验室检测中的临床显著问题发生在每1000例初级保健患者访问中的1.1例.
- 临床医生认为,这些实验室问题的显著比例 (27%) 影响了患者的护理.
- 针对测试订购和样本处理的干预措施可能有助于减少初级保健中的实验室错误.
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