Research Article
BibTex RIS Cite

PREANALİTİK SÜREÇTE HASTANE ÜNİTELERİNİN ROLÜ

Year 2020, Volume: 1 Issue: 1, 1 - 7, 23.06.2020

Abstract

Giriş: Sağlık hizmetinin en önemli birimlerinden biri klinik laboratuarlardır. Klinik laboratuvarlardaki toplam test süreci kompleks ve çok basamaklı bir süreçtir. Toplam test süreci pre-analitik, analitik ve post-analitik olarak üç ana fazda değerlendirilmektedir. Preanalitik faz toplam test sürecinin en karmaşık ve kontrol edilmesi güç aşamasıdır.
Amaç: Çalışmamızda Kırıkkale Yüksek İhtisas Hastanesi Biyokimya Laboratuvarı’nda preanalitik süreçte yer alan, reddedilen numunelerin ret nedenleri ve gönderildikleri birimlere göre sınıflandırılması amaçlanmıştır.
Gereç ve yöntem: Bir yıllık dönemde merkez laboratuvarında (acil,rutin) çalışılan biyokimya örnekleri retrospektif olarak incelendi. Çalışmaya sadece preanalitik hata nedeniyle reddedilen örnekler dahil edilmiştir. Elde edilen ve¬riler, her bir çalışma grubu (acil servis,çocuk acil, yoğun bakımlar ve diğer servisler) için örnek/hata sayıları ve hata yüzdeleri olarak sunulmuştur. Preanalitik süreçteki hatalı örnekler ayrıca spesifik hata kay¬naklarına göre kategorize edilmiş (hatalı barkodlama, hemoliz/lipemik, pıhtılı örnek, eksik örnek, uygunsuz tüp veye örnek kabı ve diğer hatalar) ve hata sıklığı değerlendi¬rilmiştir. Her bir kategori için hata yüzdeleri, hata sayısının, total hataya ve çalışma grubundaki örnek sayısına oranı olarak hesaplanmış ve yüzde olarak ifade edilmiştir. Bu hatalı örneklerin geldiği servislere göre dağılımları verilmiştir.
Bulgular: Çalışma grubuna göre preanalitik hata sıklığı %2.65 olarak bu¬lundu. Hata yüzdelerine göre ilk dört çalışma grubu sırasıyla acil servis (%1.37), yoğun bakımlar (%0.31) çocuk acil servisi (%0.28) ve dahiliye servisi (%0.12) bulundu. En sık ilk üç hata nedeni ise sırasıyla, hemoliz/lipemi (%1.23), pıhtılı örnek (%0.50) ve eksik örnek alımı (%0.28) olarak gözlendi.
Sonuç: Verimli ve iyi organize edilmiş sağlık çalışanları ile hata azaltımı işletme maliyetinde azalma ve artan gelirle sonuçlanır.

References

  • Kaynaklar 1. Coşkun, A., Inal, T., Unsal, I., Serteser, M,.(2010). Six Sigma as a Quality Management Tool: Evaluation of Performance in Laboratory Medicine. Quality Management and Six Sigma , 247–61.
  • 2. Englezopoulou, A., Kechagia, M., Chatzikiriakou, R., Kanellopoulou, M., (2016). Pre Analytical Errors as Quality Indicators in Clinical Laboratory. AustinJ Public Health Epidemiol,3(5):1-8
  • 3. Lippi, G., Mattiuzzi. C., Favaloro, E.J.,(2006). Pre-analytical variability and quality of diagnosis testing. Looking at the moon and gazing beyond the finger. N Z J Med Lab Sci,69:4-8.
  • 4. Plebani, M.,(2006). Errors in clinical laboratories or errors in laboratory medicine? Clin Chem Lab Med, 44(6):750–759
  • 5. Plebani, M., Sciacovelli, L., Aita, A., Padoan, A., Chiozza, M.L.,(2014). Quality indicators to detect pre analytical errors in laboratory testing. Clinica Chimica Acta 432, 44–48
  • 6. Lippi, G., Chance, J.J., Church, S., et al. (2011). Preanalytical quality improvement: from dream to reality. Clin Chem Lab Med, 49(7):1113-26.
  • 7. Plebani, M.,(2013). The CCLM contribution to improvements in quality and patient safety. Clin Chem Lab Med, 51(1):39-46.
  • 8. Lippi, G.,(2011). Risk management in the pre-analytical phase, 21st International Congress of Clinical Chemistry and Laboratory Medicine 19th IFCC-EFCC European Congress of Clinical Chemistry and Laboratory Medicine8th Annual Meeting of the German Society of Clinical Chemistry and Laboratory Medicine, Berlin, IFCCWorldLab- EuroMedLab Berlin, 85.
  • 9. Plebani, M., Carraro, P.,(1997). Mistakes in a stat laboratory: types and frequency. Clin Chem, 43(8):1348-51. 10. Wiwanitkit, V.,(2001). Types and frequency of preanalytical mistakes in the first Thai ISO 9002: 1994 certified clinical laboratory, a 6-month monitoring. BMC Clin Pathol, 1(1):55-9.
  • 11. Lippi, G., Bassi, A., Brocco ,G.,(2006). Preanalytic error tracking in a laboratory medi-cine department: results of a 1-year experience. Clin Chem, 52(7):1442-3.
  • 12. Plebani, M., Ceriotti, F., Messeri, G.,(2006). Laboratory network of excellence: enhancing pa¬tient safety and service effectiveness. Clin Chem Lab Med, 44(2):150-60.
  • 13. Clinical Lboratory Standards Institute. Procedure for the collection of diagnostic blood specimens by venipuncture; approved standard- sixth edition. CLSI document GP41 A6. Clinical Laboratory Standards Institute, Wayne, Pennsylvania, USA,02007.
  • 14. Dugan, L., Leech, L., Speroni, K.G.,(2005). Factors affecting hemolysis rates in blood samples drawn from newly placed IV sites in the emergency department. J Emerg Nurs,31:338-45.
  • 15. Baer, D., Ernst, D.J., Willeford, S.I.,(1999). Investigating elevated potassium values. MLO Med Lab Ods 2006;38:24-31. situation. Postgrad Med J ,75:459-62.
  • 16. Statland, B.E., Bokelund, H., Winkel, P.,(1974). Factors contributing to intra-individual variation of serum constituents: 4. Effect of posture and tourniquet application on variation of serum constituents in healthy subjects. Clin Chem, 20:1513-9.
  • 17. Saleem, S., Mani, V., Chadwick, M.A.,(2009). A prospective study of causes of haemolysis during venipuncture: tourniquet time should be kept to a minimum. Ann Clin Biochem, 46:244-6.
  • 18. Venöz Kan Alma Filebotomi Kılavuzu Turk Biyokimya Derneği. 2015-ANKARA ISBN 978 605-87229-3-4).
  • 19. WHO guidelines on drawing blood: best practice in phlebotomy. http://whqlibdoc. who.int/publications/2010/9789241599221_eng.pdf.
Year 2020, Volume: 1 Issue: 1, 1 - 7, 23.06.2020

Abstract

References

  • Kaynaklar 1. Coşkun, A., Inal, T., Unsal, I., Serteser, M,.(2010). Six Sigma as a Quality Management Tool: Evaluation of Performance in Laboratory Medicine. Quality Management and Six Sigma , 247–61.
  • 2. Englezopoulou, A., Kechagia, M., Chatzikiriakou, R., Kanellopoulou, M., (2016). Pre Analytical Errors as Quality Indicators in Clinical Laboratory. AustinJ Public Health Epidemiol,3(5):1-8
  • 3. Lippi, G., Mattiuzzi. C., Favaloro, E.J.,(2006). Pre-analytical variability and quality of diagnosis testing. Looking at the moon and gazing beyond the finger. N Z J Med Lab Sci,69:4-8.
  • 4. Plebani, M.,(2006). Errors in clinical laboratories or errors in laboratory medicine? Clin Chem Lab Med, 44(6):750–759
  • 5. Plebani, M., Sciacovelli, L., Aita, A., Padoan, A., Chiozza, M.L.,(2014). Quality indicators to detect pre analytical errors in laboratory testing. Clinica Chimica Acta 432, 44–48
  • 6. Lippi, G., Chance, J.J., Church, S., et al. (2011). Preanalytical quality improvement: from dream to reality. Clin Chem Lab Med, 49(7):1113-26.
  • 7. Plebani, M.,(2013). The CCLM contribution to improvements in quality and patient safety. Clin Chem Lab Med, 51(1):39-46.
  • 8. Lippi, G.,(2011). Risk management in the pre-analytical phase, 21st International Congress of Clinical Chemistry and Laboratory Medicine 19th IFCC-EFCC European Congress of Clinical Chemistry and Laboratory Medicine8th Annual Meeting of the German Society of Clinical Chemistry and Laboratory Medicine, Berlin, IFCCWorldLab- EuroMedLab Berlin, 85.
  • 9. Plebani, M., Carraro, P.,(1997). Mistakes in a stat laboratory: types and frequency. Clin Chem, 43(8):1348-51. 10. Wiwanitkit, V.,(2001). Types and frequency of preanalytical mistakes in the first Thai ISO 9002: 1994 certified clinical laboratory, a 6-month monitoring. BMC Clin Pathol, 1(1):55-9.
  • 11. Lippi, G., Bassi, A., Brocco ,G.,(2006). Preanalytic error tracking in a laboratory medi-cine department: results of a 1-year experience. Clin Chem, 52(7):1442-3.
  • 12. Plebani, M., Ceriotti, F., Messeri, G.,(2006). Laboratory network of excellence: enhancing pa¬tient safety and service effectiveness. Clin Chem Lab Med, 44(2):150-60.
  • 13. Clinical Lboratory Standards Institute. Procedure for the collection of diagnostic blood specimens by venipuncture; approved standard- sixth edition. CLSI document GP41 A6. Clinical Laboratory Standards Institute, Wayne, Pennsylvania, USA,02007.
  • 14. Dugan, L., Leech, L., Speroni, K.G.,(2005). Factors affecting hemolysis rates in blood samples drawn from newly placed IV sites in the emergency department. J Emerg Nurs,31:338-45.
  • 15. Baer, D., Ernst, D.J., Willeford, S.I.,(1999). Investigating elevated potassium values. MLO Med Lab Ods 2006;38:24-31. situation. Postgrad Med J ,75:459-62.
  • 16. Statland, B.E., Bokelund, H., Winkel, P.,(1974). Factors contributing to intra-individual variation of serum constituents: 4. Effect of posture and tourniquet application on variation of serum constituents in healthy subjects. Clin Chem, 20:1513-9.
  • 17. Saleem, S., Mani, V., Chadwick, M.A.,(2009). A prospective study of causes of haemolysis during venipuncture: tourniquet time should be kept to a minimum. Ann Clin Biochem, 46:244-6.
  • 18. Venöz Kan Alma Filebotomi Kılavuzu Turk Biyokimya Derneği. 2015-ANKARA ISBN 978 605-87229-3-4).
  • 19. WHO guidelines on drawing blood: best practice in phlebotomy. http://whqlibdoc. who.int/publications/2010/9789241599221_eng.pdf.
There are 18 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Articles
Authors

Seydi Ali Peker

Publication Date June 23, 2020
Published in Issue Year 2020 Volume: 1 Issue: 1

Cite

APA Peker, S. A. (2020). PREANALİTİK SÜREÇTE HASTANE ÜNİTELERİNİN ROLÜ. Cerrahi Ameliyathane Sterilizasyon Enfeksiyon Kontrol Hemşireliği Dergisi, 1(1), 1-7.