Critical results in medical laboratory. management and communication

Keywords: critical results test, patient safety, ISO 15189: 2021, process management, postanalytical phase

Abstract

The medical community is gaining increased attention to streamlining a clear mechanism for reporting critical test results in the clinic. DSTU ISO 15189: 2015 requires laboratories to report critical test results to clinitians within a specified period of time. Moreover, they should have a clearly established procedure in place. In order to standardize processes and avoid misunderstandings between stakeholders, international organizations (RCPA, AACB, CLSI) have developed terminology, communication algorithm and requirements for data documentation. In order to harmonize this part, a lot of surveys have been conducted as to which analytes should be included in the notification sheet and, in particular, the limits of their values for hematological, hemostasiological and biochemical studies. According to ICSH recommendations, critical risk results include hemoglobin, leukocytes, neutrophils, platelets, activated partial thromboplastin time (aPTT), prothrombin time (PT) / international normalization ratio (INR) and fibrinogen. The laboratories include different biochemical tests in the alert list. The most common analytes are glucose, potassium, sodium and calcium. It should be noted that this alert list is only recommended for clinical laboratories, such as the number of indicators and alert threshold of analytes should be agreed with the clinicians of a particular medical institution, taking into account their experience and local patient population. The developed recommendations will allow to react as quickly as possible to situations that may threaten patient’s life, provide qualified medical care in a timely manner and adjust work processes in accordance with the requirements of international standards.

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Author Biographies

Hanna Maksymyuk, Danylo Halytsky Lviv National Medical University

Dr.Sc. Professor of the Department of Clinical Laboratory Diagnostic FPGE Danylo Halytsky Lviv National Medical University, 69, Pekarska str., Lviv, Ukraine, 79010

Oksana Yastremska, Danylo Halytsky Lviv National Medical University

MD, PhD, Associate Professor of the Department of Clinical Laboratory Diagnostic FPGE Danylo Halytsky Lviv National Medical University, 69, Pekarska str., Lviv, Ukraine, 79010

Andriy Kost, Danylo Halytsky Lviv National Medical University

MD, PhD, Associate Professor of the Department of Clinical Laboratory Diagnostic FPGE Danylo Halytsky Lviv National Medical University, 69, Pekarska str., Lviv, Ukraine, 79010

Natalija Boykiv, Danylo Halytsky Lviv National Medical University

MD, PhD, Associate Professor of the Department of Clinical Laboratory Diagnostic FPGE Danylo Halytsky Lviv National Medical University, 69, Pekarska str., Lviv, Ukraine, 79010

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Published
2021-12-01
How to Cite
Maksymyuk, H., Yastremska, O., Kost, A., & Boykiv, N. (2021). Critical results in medical laboratory. management and communication. The Journal of V. N. Karazin Kharkiv National University, Series "Medicine", (43). https://doi.org/10.26565/2313-6693-2021-43-13