Read by QxMD icon Read

Notification of critical lab values

Juan Xing, Lindsey Seigh, Sara E Monaco, N Paul Ohori, Samuel A Yousem, Rajnikant Amin, Liron Pantanowitz
BACKGROUND: Critical values have been well established and accepted in laboratory medicine, but to the authors' knowledge are less well accepted in anatomic pathology. Herein, the authors used a reporting process whereby reports with critical diagnoses were coded to ensure that the patient's clinical team was promptly notified electronically of this finding. The aim of the current study was to determine whether this coding mechanism was used appropriately for critical cytopathology diagnoses in the study health care system...
September 2017: Cancer Cytopathology
Elisa Piva, Laura Sciacovelli, Michela Pelloso, Mario Plebani
Formerly defined "critical values", the importance of critical results (CRs) management in patient care has grown in recent years. According to the George Lundberg definition the result becomes "critical" when, exceeding actionable thresholds, it suggests imminent danger for the patient, unless appropriate therapy is initiated promptly. As required in most important accreditation standards, such as the ISO:15,189 or the Joint Commission standards, a quality reporting system should deliver the correct result to the appropriate clinician in a time-frame that ensures patient safety...
July 2017: Clinical Biochemistry
Greer Dawson, Robin Gilmour, Sean Tobin, Joanne Travaglia
OBJECTIVE: In New South Wales (NSW), influenza surveillance is informed by a number of discrete data sources, including laboratories, emergency departments, death registrations and community surveillance programs. The purpose of this study was to evaluate the NSW influenza surveillance system using the US Centers for Disease Control and Prevention guidelines for evaluating public health surveillance systems. Importance of study: Having a strong influenza surveillance system is important for both seasonal and pandemic influenza preparedness...
April 15, 2016: Public Health Research & Practice
Caleb V Grieme, Dena R Voss, Karin E Olson, Scott R Davis, Jeff Kulhavy, Matthew D Krasowski
OBJECTIVE: Panels of clinical laboratory testing may generate "incidental" critical values from unordered parameters. Existing regulations do not clearly delineate guidelines for handling incidental critical values. The objective of this study was to examine the patterns and clinical utility of incidental critical values at 2 critical care laboratories within an academic medical center. METHODS: In this retrospective study, the electronic health record and laboratory information system were reviewed for incidental critical results obtained from blood gas analyzer analysis of whole blood specimens between November 2010 and August 2014...
November 2016: Laboratory Medicine
Renato Tozzoli, Danilo Villalta, Nicola Bizzaro
Standardization and harmonization are complementary tools to achieve higher testing quality in laboratory medicine. Both are of great relevance and are strongly needed in autoimmune diagnostics, due to the impressive advance in basic research and technological development observed in this diagnostic field in recent years that has led to the introduction of many new tests and new analytical methods. It is, therefore, essential that this strong innovative thrust is translated into clinical practice in a coordinated way to avoid confusion and the risk of potentially harmful errors for the patient...
August 2017: Clinical Reviews in Allergy & Immunology
T B Keng, B De La Salle, G Bourner, A Merino, J-Y Han, Y Kawai, M T Peng, R McCafferty
INTRODUCTION: These recommendations are intended to develop a consensus in the previously published papers as to which parameters and what values should be considered critical. A practical guide on the standardization of critical results management in haematology laboratories would be beneficial as part of good laboratory and clinical practice and for use by laboratory-accrediting agencies. METHODS: A working group with members from Europe, America, Australasia and Asia was formed by International Council for Standardization in Haematology...
October 2016: International Journal of Laboratory Hematology
Cody Benthin, Sonal Pannu, Akram Khan, Michelle Gong
RATIONALE: The nature, variability, and extent of early warning clinical practice alerts derived from automated query of electronic health records (e-alerts) currently used in acute care settings for clinical care or research is unknown. OBJECTIVES: To describe e-alerts in current use in acute care settings at medical centers participating in a nationwide critical care research network. METHODS: We surveyed investigators at 38 institutions involved in the National Institutes of Health-funded Clinical Trials Network for the Prevention and Early Treatment of Acute Lung Injury (PETAL) for quantitative and qualitative analysis...
October 2016: Annals of the American Thoracic Society
Yang Fei, Fengfeng Kang, Wei Wang, Haijian Zhao, Falin He, Kun Zhong, Zhiguo Wang, Wenxiang Chen
BACKGROUND: The aim of the study was to promote the establishment and implementation of quality indicators (QIs) in clinical laboratories, catch up with the state of art, and provide preliminary quality specifications for established QIs. METHODS: Clinical laboratories from different provinces in China were included in this QIs survey in 2015. All participants were asked to collect data related to QIs and complete QIs questionnaires. Defect percentages and sigma values were calculated for each QI...
August 1, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
Lara Milevoj Kopcinovic, Jasenka Trifunović, Tihana Pavosevic, Nora Nikolac
INTRODUCTION: Poor harmonization of critical results management is present in various laboratories and countries, including Croatia. We aimed to investigate procedures used in critical results reporting in Croatian medical biochemistry laboratories (MBLs). MATERIALS AND METHODS: An anonymous questionnaire, consisting of 24 questions/statements, related to critical results reporting procedures, was send to managers of MBLs in Croatia. Participants were asked to declare the frequency of performing procedures and degree of agreement with statements about critical values reporting using a Likert scale...
2015: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
Ye Guo, Qian Chen, Wei Wu, Wei Cui
OBJECTIVE: To establish a system of monitoring the key indicator of quality for inspection (KIQI) on a laboratory information system (LIS), and to have a better management of KIQI. METHODS: Clinical sample made in PUMCH were collected during the whole of 2014. Next, interactive input program were designed to accomplish data collecting of the disqualification rate of samples, the mistake rate of samples and the occasions of losing samples, etc. Then, a series moment of sample collection, laboratory sample arrived, sample test, sample check, response to critical value, namely, trajectory information left on LIS were recorded and the qualification rate of TAT, the notification rate of endangering result were calculated...
March 31, 2015: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Rasha Mosallam, Samaa Zenhom Ibrahim
OBJECTIVES: To examine critical value reporting policies and practices and to identify critical value ranges for selected common laboratory assays at inpatient division of laboratories of Alexandria hospitals. METHODS: A cross-sectional descriptive study design was used. Subjects were from inpatient division of all laboratories of Alexandria hospitals (40 laboratories). Data were collected using a questionnaire composed of 4 sections. The first section explored hospital and laboratory characteristics...
June 12, 2015: Journal of Patient Safety
E Schapkaitz, B Levy
BACKGROUND: Critical value policies are used by clinical laboratories to decide when to notify caregivers of life-threatening results. There, however, remains much debate regarding which tests should be included in critical value lists and clinically relevant limits. METHOD: An electronic survey was designed to determine the critical value policies of specialists for haematology tests in South African intensive care units. Data collected included a demographic component, critical value policies and critical value reporting...
October 2015: International Journal of Laboratory Hematology
Rachna Agarwal, Neelam Chhillar, Chandra B Tripathi
During post-analytical phase, critical value notification to responsible caregiver in a timely manner has potential to improve patient safety which requires cooperative efforts between laboratory personnel and caregivers. It is widely accepted by hospital accreditors that ineffective notification can lead to diagnostic errors that potentially harm patients and are preventable. The objective of the study was to assess the variables affecting critical value notification, their role in affecting it's quality and approaches to improve it...
January 2015: Indian Journal of Clinical Biochemistry: IJCB
Shu-Wen Lin, Wen-Yi Kang, Dong-Tsamn Lin, James Lee, Fe-Lin Wu, Chuen-Liang Chen, Yufeng J Tseng
BACKGROUND: Computerized alert and reminder systems have been widely accepted and applied to various patient care settings, with increasing numbers of clinical laboratories communicating critical laboratory test values to professionals via either manual notification or automated alerting systems/computerized reminders. Warfarin, an oral anticoagulant, exhibits narrow therapeutic range between treatment response and adverse events. It requires close monitoring of prothrombin time (PT)/international normalized ratio (INR) to ensure patient safety...
2014: BMC Medical Genomics
Chinelo P Onyenekwu, Careen L Hudson, Annalise E Zemlin, Rajiv T Erasmus
BACKGROUND: Early notification of critical values by the clinical laboratory to the treating physician is a requirement for accreditation and is essential for effective patient management. Many laboratories automatically repeat a critical value before reporting it to prevent possible misdiagnosis. Given today's advanced instrumentation and quality assurance practices, we questioned the validity of this approach. We performed an audit of repeat-testing in our laboratory to assess for significant differences between initial and repeated test results, estimate the delay caused by repeat-testing and to quantify the cost of repeating these assays...
December 2014: Clinical Chemistry and Laboratory Medicine: CCLM
Elisa Piva, Michela Pelloso, Laura Penello, Mario Plebani
OBJECTIVE: Failure to adequately communicate a laboratory critical value (CV) is a potential cause of adverse events. The harmonization of CV reporting is increasingly recognized as a key issue in ensuring patient care and minimizing harm. With ongoing improvements in CV reporting, the patient's outcome should be audited to assess the effectiveness of CV notification. DESIGN AND METHODS: We report the data audited throughout a six month-period during which an analysis was made of CVs, and we describe the approach of clinicians and general practitioners (GPs), and their decision making following CV reporting...
September 2014: Clinical Biochemistry
Christopher M Lehman, Peter J Howanitz, Rhona Souers, Donald S Karcher
CONTEXT: A common laboratory practice is to repeat critical values before reporting the test results to the clinical care provider. This may be an unnecessary step that delays the reporting of critical test results without adding value to the accuracy of the test result. OBJECTIVES: To determine the proportions of repeated chemistry and hematology critical values that differ significantly from the original value as defined by the participating laboratory, to determine the threshold differences defined by the laboratory as clinically significant, and to determine the additional time required to analyze the repeat test...
June 2014: Archives of Pathology & Laboratory Medicine
A McFarlane, B Aslan, A Raby, G Bourner, R Padmore
INTRODUCTION: Critical values are life-threatening results that require immediate notification to the patient's healthcare provider. Accreditation bodies require laboratories to establish critical values. A survey of Ontario laboratories was conducted to determine current practice for critical values in hematology. METHODS: The survey was sent to 182 participants questioning sources for establishing critical values, levels, review frequency, delta checks, and reporting...
February 2015: International Journal of Laboratory Hematology
A F Guzmán-González, F Navajas-Luque, J de la Torre-Fernández
INTRODUCTION: The objective was to describe and evaluate a new communication protocol of reporting critical results applied to Microbiology in a health area of Andalusia. MATERIAL AND METHODS: The size and type of the critical values of Microbiology are analyzed for primary care patients. A new computerized reporting system was analyzed, in real time, through Diraya Digital Health Records, which integrates the analytical test module (MPA). The protocol is complemented, in collaboration with the Information Technology (IT), with the Junta de Andalucía short message service (SMS) "WebMovil"...
March 2014: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
Véronique Quillien, Audrey Lavenu, Marc Sanson, Michèle Legrain, Pierre Dubus, Lucie Karayan-Tapon, Jean Mosser, Koichi Ichimura, Dominique Figarella-Branger
The methylation of O(6)-methylguanine DNA methyltransferase (MGMT) gene promoter is a key biological marker in clinical neuro-oncology. Nevertheless, there is no consensus concerning the best technique for its assessment. In a recent study comparing five methods to analyze MGMT status, we found that the best prediction of survival was obtained with a pyrosequencing (PSQ) test assessing methylation of 5 CpGs (CpGs 74-78). In the present study we extended our PSQ analysis to 16 CpGs (CpGs 74-89) identified as critical for transcriptional control of the gene...
February 2014: Journal of Neuro-oncology
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"