背景:风险管理包括识别各种风险,评估发生的可能性,并评估其后果的严重性。由于临床实验室整体参与患者护理,在某些情况下,实验室的风险可能会带来严重后果。本研究旨在在临床实验室中利用简单的风险管理技术。
方法:对某三级医院病理实验室的所有潜在风险进行鉴定,并将其分类为自然灾害,环境,与人力相关的,预分析,分析,分析后,和实验室危险相关的风险通过头脑风暴会议。根据部门和医院记录估计每种风险的发生概率。风险的可能影响(1-10分)被归类为灾难性的,关键,严肃,微不足道,和微不足道的。通过将发生概率和影响评分相乘来计算未加权风险评分。
结果:样品与抗凝剂比例不足的发生概率最高(22.85%),其次是分析数量不足(7.30%)和实验室信息系统(LIS)细分(6.58%)。我们研究中最高的未加权风险评分是样本与抗凝剂比率不足(评分91.40),其次是标记不当的样本(得分为35.61),人力能力问题(32.88分),样本不足以进行分析(评分29.20),和LIS细分(得分26.30)。
结论:我们发现在所有类别中,涉及分析前阶段的风险得分最高.其他重要风险包括人力能力问题,需要继续对工作人员进行在职培训作为降低风险的战略。头脑风暴和概率分析可以很容易地用于临床实验室的风险管理。
BACKGROUND: Risk management includes identifying various risks, assessing the probability of occurrence, and evaluating the severity of their consequences. As clinical laboratories are integrally involved in patient care, risks in the laboratories could present grave consequences in some instances. This study aimed to utilize simple techniques for risk management in a clinical laboratory.
METHODS: All potential risks in the pathology laboratory of a tertiary-level hospital were identified and classified into natural calamity, environmental, manpower-related, pre-analytical, analytical, post-analytical, and laboratory hazard-related risks through a brainstorming session. The probability of occurrence of each risk was estimated from departmental and hospital records. The possible impact of risk (score 1-10) was categorized into catastrophic, critical, serious, minor negligible, and insignificant. The unweighted risk score was calculated by multiplying the probability of occurrence and impact score.
RESULTS: Inadequate sample-to-anticoagulant ratio had the highest probability of occurrence (22.85%), followed by quantity insufficient for analysis (7.30%) and laboratory information system (LIS) breakdown (6.58%). The highest unweighted risk score in our study was inadequate sample-to-anticoagulant ratio (score 91.40), followed by improperly labeled samples (score 35.61), manpower competency issues (score 32.88), sample insufficient for analysis (score 29.20), and LIS breakdown (score 26.30).
CONCLUSIONS: We found that among all the categories, risks involving the pre-analytical phase had the highest risk scores. The other important risks included manpower competency issues requiring continued on-the-job training of staff as a risk reduction strategy. Brainstorming and probability analysis could be easily used for risk management in a clinical laboratory.