EVALUASI PENETAPAN NILAI KRITIS PARAMETER HEMATOLOGI  DI INSTALASI LABORATORIUM KLINIK RSUD WATES

PRITA MURANI NUGRAHETI; TEGUH TRIYONO

PRITA MURANI NUGRAHETI DEPARTEMEN PATOLOGI KLINIK, FAKULTAS KEDOKTERAN, UNIVERSITAS ISLAM INDONESIA YOGYAKARTA
TEGUH TRIYONO 2DEPARTEMEN PATOLOGI KLINIK DAN KEDOKTERAN LABORATORIUM FAKULTAS KEDOKTERAN, KESEHATAN MASYARAKAT DAN KEPERAWATAN UNIVERSITAS GADJAH MADA/RSUP DR.SARDJITO YOGYAKARTA

Keywords: management, patient safety, clinical laboratory, critical value, hematology.

Abstract

Timely and accurate reporting critical value of laboratory examination helps support decision making, improves patient safety, and promotes successful therapy. A very extensive or very exclusive list of critical values has the potential to cause problems. This study is aimed to evaluate the determination of critical values, especially hematological parameters, in the Clinical Laboratory Installation of RSUD Wates. This study is a descriptive study of laboratory examination data for hematological parameters at RSUD Wates on January-June 2021. The proportion of critical values is calculated according to the cut off determined by the Clinical Laboratory of RSUD Wates. The cut off of critical values for the Laboratory of RSUP Dr. Sardjito was used as a comparison. The difference in proportion between the two groups was analyzed using the Chi Square test with p<0.05 is statistically significant. The most examination data was leukocyte count (7903 or 25.1%) and the examination with the most critical values is hematocrit (363 or 4.59%). There is a statistically difference in the number of critical values on the parameters of hematocrit, platelet count, leukocyte count and APTT, between the use of the cut off critical value of the clinical laboratory of RSUD Wates compared to the laboratory of RSUP Dr. Sardjito (p<0.01). The different two cut offs has the potential to increase the workload of laboratory staff and more time in reporting critical values. The cut off of critical values at the Clinical Laboratory of RSUD Wates should be reviewed, revised and updated regularly.

References

Rocha BCB, Alves JAR, Pinto FPD, Mendes ME, Sumita NM. The critical value concept in clinical laboratory. J Bras Patol e Med Lab 2016; 52: 17–20.

AlSadah K, S El-Masry O, Alzahrani F, Alomar A, Ghany MA. Reporting Clinical Laboratory Critical Values: A Focus On The Recommendations Of The American College Of Pathologists. J Ayub Med Coll Abbottabad 2019; 31: 612–618.

Cv C. Assessing the turn over time of. 2019; 9: 17–19.

Lundberg GD. Critical (panic) value notification: an established laboratory practice policy (parameter). JAMA J Am Med Assoc 1990; 263: 709–709.

Liebow EB, Derzon JH, Fontanesi J, Favoretto AM, Baetz RA, Shaw C, et al. Effectiveness of automated notification and customer service call centers for timely and accurate reporting of critical values: A laboratory medicine best practices systematic review and meta-analysis. Clin Biochem 2012; 45: 979–987.

McPherson RA, Pincus MR. Henry’s Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. St. Louis, Missouri: Elsevier, 2017.

Campbell CA, Horvath AR. Towards harmonisation of critical laboratory result management - Review of the literature and survey of Australasian practices. Clin Biochem Rev 2012; 33: 149–160.

Tripathi CB. Study of Variables Affecting Critical Value Notification in a Laboratory Catering to Tertiary Care Hospital. 2015; 30: 89–93.

Dighe AS, Rao A, Coakley AB, Lewandrowski KB. Analysis of laboratory critical value reporting at a large academic medical center. Am J Clin Pathol 2006; 125: 758–764.