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Notification of critical values

Mario Plebani ; Department of Laboratory Medicine, University-Hospital, Padova, Italy
Elisa Piva ; Department of Laboratory Medicine, University-Hospital, Padova, Italy

Puni tekst: engleski pdf 106 Kb

str. 173-178

preuzimanja: 907



Although it is widely agreed that clinicians must be informed of abnormal laboratory results that constitute a life-threatening condition for the patient, as well as for any values for which delays in reporting can result in adverse outcomes for patients, the criteria for considering tests results critical are controversial. Moreover large variability exists in defining low and high critical values cut-offs and in notifying them to caregivers. In Italy, basically the critical values were communicated to physicians ordering the tests (37.3%), nurses (29.4%) and at a lower extent to any physician on call (17.9%), any people working in the ward (11.9%), and clerks (3%). Again some differences with the US have been demonstrated, being the notification directed also to patients (12.2%), and even to the general practitioner's relatives. Some interesting differences were observed when comparing the Italian and US policies in critical values notification. In Italy the notification is made principally by laboratory managers, i.e., pathologists, biologists, doctors on call, rather than by laboratory technologists, who provide the notification in only 11.1% of institutions. In turn, the professionals involved in communicating critical values in US institutions are usually laboratory technicians or technologists who performed the tests. The reporting of critical values from the laboratory to caregivers is still made mainly by telephone (81.1% in the Italian survey). Less commonly used means of communication included computer (10%), fax (1.1%) or all tools indicated. In the US, laboratories have created call centers in order to centralize critical value reporting.

Ključne riječi

critical values; notification of critical values; clinical laboratories; post-analytical phase; errors in laboratory medicine

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