紧急值报告的监测  

Monitor of Critical Values Notification

作　　者：宋昊岚[1] 黄亨建[1] 李萍[1] 

机构地区：[1]四川大学华西医院实验医学科,成都610041

出　　处：《现代检验医学杂志》2008年第2期124-126,共3页Journal of Modern Laboratory Medicine

基　　金：中华医学基金会资助项目(CMB-00737)

摘　　要：目的通过监测紧急值报告率评价紧急值的实时报告情况,为满足临床需要,改进实验室服务质量提供客观依据。方法根据临床需要,临床生化实验室设置了血钾、血糖、动脉血pH的紧急值范围,并要求实验室工作人员在病人结果超出范围时及时通知相关医生。每月统计紧急值报告率,每年进行总结,一旦出现紧急值报告率下降,则立即查找原因,并采取措施改进。结果紧急值通知已执行了3年,平均紧急值报告率为63.8%,最低紧急值报告率为10%,最高紧急值报告率为99%。低紧急值报告率的主要原因为:高负荷的工作量及工作人员对紧急值的理解及责任心。因此,提高紧急值报告率的主要措施为优化工作流程及对员工的持续教育和培训,令其理解紧急值对病人的重要性并加强责任心。结论紧急值需要立即通知临床医生,并根据结果对病人立即采取措施的实验室数据。紧急值通知率的监测不仅是质量改进的重要要素,也是质量管理的工具之一。通过分析紧急值通知率,可以发现质量管理中的缺陷,并在客观证据下进行持续性质量改进,为临床医生及病人提供更好的服务。Objective To evaluate the critical values notification in real time by monitoring critical value notification rate （%）,and provide objective evidence for laboratory quality continue improvement. Methods Set critical values of potassium,glucose and pH,and were asked to notify physician in real time when the patient results exceeded critical values. Sum-marled and evaluated the notification rate month, Annual summary was reported in the end of a year. Whenever the notifi-cation rate was decreased,looked for the reasons and improved it, Results The average critical values notification rate（%）was 63.8%,the lowest was 10%,the highest was 99%. The main cause of low notification rate was due to huge volume workload and staff responsibility. Continue stsff training and workflow improvement were effective to increase notification.Conclusion Critical values are defined as results requiring immediate notification to the physician for necessary patient e-valuation or treatment. Critical value notification has been routine practiced for 3 years in our clinical chemistry laboratory.Monitoring of critical values notification in real time is one of important quality improvement key indicator and manage-ment tool. By evaluating the critical values notification rate we can fincl the cause and solve it by evidence supporting.

关 键 词：质量改进 紧急值报告 

分 类 号：R446.9[医药卫生—诊断学]