实验室危急值统计分析与管理

Statistical Analysis and Management of Laboratory Critical Value

目的统计实验室危急值的分布情况,分析危急值在我院实际发生情况,为危急值项目的研究及危急值项目界限值优化设置提供参考,进而提高临床运行效率。方法收集航空总医院检验科2015年4月1日至2015年9月30日期间临检血液、凝血、生化所有危急值数据,通过统计学处理软件SPSS 20.0对数据进行统计分析。结果在所有危急值患者中,住院患者占据了61.95%,门诊患者占23.09%。危急值数量排前五位的项目分别是WBC、PLT、PT、APTT和淀粉酶项目。发生危急值最多的前五位科室分别为ICU、心血管内科、肿瘤科、急诊科和儿科。结论住院患者是危急值发生的主要人群,但危急值在门诊患者中也占有相当大的比例,且向门诊通报危急值存在一定困难,应通过改进信息系统和医院管理流程加强对门诊患者的危急值的管理。在避免漏报、误报危急值的同时,定期评估危急值阈值,强化危急值管理,做到持续改进。

Objective To analyze the distribution of the critical values of the laboratory, assess the critical value in the actual situation in our hospital, and provide a reference for critical value and optimization of its boundary value in order to improve clinical efficiency, and continuously meet the patient needs. Methods Collect the critical value data from of routine blood test, blood coagulation and biochemistry from September 30, 2015 to April 1, 2015 in our hospital., The data was statistically analyzed with software SPSS 20. Results Out of all the critical patients, in-patients accounted for 61.95%, out-patient accounted for 23. 09%. The number of of the top five critical values were PLT, WBC, PT, APTT and amylase. The top five departments where critical value occurred were ICU, cardiovascular department of internal medicine, oncology department, emergency department and pediatric department. Conclusion Hospitalized patients are the main sources of critical value, but the critical value from outpatient service also occupies a large proportion, in which situation it could be difficult to alert patient in a timely manner. We should improve the information system and hospital management process to strengthen the critical value management. At the same time each laboratory should assess critical value regularly, strengthen its management, and make continuous improvement in order to avoid the missing and false critical value.