SummaryBackgroundThe most common sources of error in the preanalytical phase are considered to be at the stage of patient preparation and sample collection. In order to reduce the preanalytical errors, we aimed to determine the level of phlebotomists knowledge about the preanalytic phase before and after planned trainings in the study.MethodsTraining about preanalytical processes was given to the 454 health professionals and the majority of them were employed as nurse. Questionnaires before and after training were conducted. In order to assess the effect of the training into the process, preanalytical error rates were calculated before and after training.ResultsThe total correct answer rates of vocational school of health diplomaed were statistically lower than the total correct answer rates of other. It was observed significantly increase in the rate of correct answers to questionnaire and significantly decrease in preanalytical error rates after training.ConclusionsThe results of the survey showed that the attitudes of the phlebotomists were diverse in the preanalytical processes according to the levels of education and their practices. By providing training to all staff on a regular basis, their information about preanalytical phase could be updated and hence, it may possible to significantly reduce the preanalytical errors in health practice and nursing science.
ÖZAmaç: Son yıllarda laboratuvar hizmetleri kullanımındaki artışın en önemli nedeni gereksiz test istemleridir. Hastanemizde istem yapılan tPSA ve sPSA testlerini inceleyerek, sPSA testi için gereksiz test istemini tPSA testi üzerinden değerlendirmeyi amaçladık. Yöntem: Hastanemizde 01.01.2011 ve 31.12.2015 tarihleri arasında istenen tPSA ve sPSA testlerini retrospektif olarak değerlendirdik. Hastadan ilk test isteminde tPSA'nın <4 ng/ml veya >10 ng/ml olması durumunda tPSA ile birlikte sPSA istendiyse bu sPSA istemlerini "gereksiz başlangıç test istemi" olarak değerlendirdik. Test istemlerinin yapıldığı bölümleri ve yıllara göre dağılımını incelendik. Bulgular: İstemi yapılan 9759 (78,8%) sPSA testinin "gereksiz test istemi" olduğunu saptadık. Bölümlere göre bir değerlendirme yapıldığında en fazla gereksiz test istem oranı olan polikliniğin nükleer tıp polikliniği (96,5%) olduğunu gördük. Servisler içinde en fazla gereksiz sPSA testi nöroloji servisi (90,6%) tarafından istenmiştir. Sonuç: Hastanemizde oluşturulan laboratuvar tetkik komisyonunca PSA istemi ile ilgili 2015 yılında kısıtlama getirilmesine rağmen, gereksiz test istem oranında istatistiksel olarak anlamlı bir değişiklik gözlenmedi (p>0,05). Laboratuvar maliyetlerinin klinisyenlerle paylaşılması, klinisyen eğitim programlarının arttırılması, test istemlerinde tanı algoritmalarının geliştirilmesi ve kullanımı gibi uygulamalar gereksiz test istemlerinin azaltılmasında etkili olabilir.Anahtar kelimeler: Prostat spesifik antijen, sağlık bakım maliyetleri, klinik laboratuvar hizmetleri ABSTRACT Objective: In recent years the main reason of the increase in the use of laboratory services is unnecessary laboratory testing. We aimed to investigate the unnecessary laboratory testing for fPSA test through tPSA test by examining the tPSA and fPSA tests which were ordered at our hospital. Methods: We evaluated the tPSA and fPSA tests retrospectively which were ordered at our hospital between 01.01.2011 and 31.12.2015. fPSA tests which were ordered simultaneously when tPSA test results were 4 ng/ml or greater than 10 ng/ml, were accepted as inappropriate initial testing. We investigated the departments that requested these tests and the distribution of these tests by years. Results: We determined that 9759 of fPSA tests (78.8%) were unnecessary laboratory testing. When evaluated according to the outpatient departments we determined that most frequently (95%) unnecessary laboratory tests was ordered by the polyclinics of nuclear medicine. While neurology service most frequently (90.6%) ordered unnecessary laboratory testing. Conclusion: Although the laboratory test commission imposed restrictions on the ordering of PSA tests in 2015, we haven't observed a statistically significant change in the frequency of unnecessary laboratory testing rate (p>0.05). The preventive measures as sharing information about the cost of laboratory tests with clinicians, increasing the number of clinician education programs, developing and using diagnostic algorithms for test ordering m...
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