医学检验危急值合理设置的临床实践

Clinical Practice of Rational Setting of Clinical Laboratory Critical Value

目的:探讨科学合理设置危急值病种阈值和报警间隔时间,对危急值的发生率、临床干预率、干预成功率、不良结果发生率以及医疗安全相关指标的影响。方法:回顾分析我院2011年和2015年检验危急值数据,分析设置病种阈值和报警间隔时间对危急值的发生率、临床干预率、干预成功率、不良结果发生率以及急救成功率、不良事件、医疗投诉的影响。结果:对危急值科学合理设置病种阈值和报警间隔时间后,危急值发生率由2.1%下降至1.2%(P<0.05),临床干预率由89.6%上升至96.3%(P<0.05),住院急救成功率由89.8%上升至95.0%(P<0.05),同时不良事件数和医疗相关投诉数均显著下降(P<0.05)。但对危急值干预成功率、不良结果发生率以及急诊急救成功率无显著影响(P>0.05)。结论:对危急值科学合理设置病种阈值和报警间隔时间能提高危急值临床干预率,提高住院急救成功率,减少不良结果发生率,降低危急值发生率,降低不良事件发生率,降低医疗相关投诉。

[Objective] To explore the impact of scientific and reasonable setting of critical value threshold and alarm interval time on the incidence of critical value, clinical intervention rate, success rate of intervention, incidence of adverse outcomes and medical safety related indicators.[Method] Through the comparison of the 2011 and 2015 critical value data, we analyzed the setting of the disease threshold and alarm interval for the incidence of critical value, clinical intervention rate, success rate of intervention, adverse outcome rates and medical safety-related data such as first aid success rates, adverse events and medical complaints.[Result] When the critical value scientifically set the disease threshold and the alarm interval, the critical value decreased from 2.1% to 1.2%(P<0.05). The clinical intervention rate increased from 89.6% to 96.3%(P<0.05). The success rate of hospitalization first aid increased from 89.8% to 95.0%(P<0.05). The number of adverse events and medical related complaints decreased significantly(P<0.05).However, there was no significant effect on the success rate of critical value intervention, the incidence of adverse outcomes, and the success rate of emergency first aid(P>0.05).[Conclusion] Rational setting of disease threshold and alarm interval for critical value can improve the clinical intervention rate of critical value, the success rate of hospitalization, reduce the incidence of adverse outcomes, the incidence of critical values, the incidence of adverse events and medical related number of complaints.