An analysis of critical value system in tertiary care hospitals in Bhubaneswar, Odisha, India.

Saurav Patra M. D.*, Brijesh Mukherjee, Sibasish Sahoo

Abstract


Critical or alert limits are the values of laboratory measurements that are regarded as requiring urgent clinical action and should be communicated to a clinician urgently. Despite this, there has been little evaluation of these values in the India. We have conducted a survey of hospitals in the city of Bhubaneswar (Odisha). The hospitals were provided with a printed questionnaire on which to give their response and data from submitted forms were compiled and evaluated. Twenty-five laboratories responded to the questionnaire; the response rate was not recorded. Twenty-three laboratories had derived their action limits locally after with their clinicians, experience over many years, and various literature. Only two laboratories quoted literature to support their values. Seven laboratories did not submit actual critical values. There was considerable variance in the values defined as critical by the responding laboratories. Each laboratory needs to evaluate its own list of acutely important Critical values and aim for a small number of analytes that are always communicated to the doctor, so that clinical needs are met without raising the risk of information.

Keywords


Critical Values; Analytes; Odisha

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References


Lundberg G. When to panic over an abnormal value. Med Lab Obs.1972; 4:47–54.

Burtis C, Ashwood E, Bruns D, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 4th ed. St Louis, MO: Elsevier Saunders; 2006.

College of American Pathologists. Laboratory General Checklist [components GEN.41320, GEN.41330, and GEN.41340]. Available at www.cap.org.

The Joint Commission. Accreditation Program: Laboratory, National Patient Safety Goals (NPSG020301). http://www.jointcommission.org

International Organization for Standardization. ISO 15189:2007: medical laboratories: particular requirements for quality and competence [items 5.5.3n, 5.8.7, and 5.8.8]. Available at www.iso.org

Medicare, Medicaid, and CLIA Programs: laboratory requirements relating to quality systems and certain personnel qualifications. Fed Regist.2003; 68:3639–3714. Codified at 42 CFR §493.

Barenfanger J, Sautter RL, Lang DL, et al. Improving patient safety by repeating (read-back) telephone reports of critical information. Am J Clin Pathol. 2004; 121:801–803.

Rensburg MA, Nutt L, Zemlin AE, et al. An audit on the reporting of critical results in a tertiary institute. Ann Clin Biochem. 2009; 46:162–164.

Emancipator K. Critical values: ASCP practice parameter. Am J Clin Pathol.1997; 108:247–253.




DOI: http://dx.doi.org/10.21746/ijbio.2013.02.009

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