Comparative analysis of stat test turnaround times between emergency department and intensive care unit / 重庆医学

Objective To provide the objective evidence for reducing stat test turnaround time (TAT) reasonably through the comparative analysis of different intervals of stat test TAT between emergency department (ED) and intensive care unit (ICU ) . Methods Laboratory information system was used to collect data about blood cell analysis and biochemical profiles of department of emergency and ICU from 1st January to 31th March ,2014 ,then comparatively analyzing different intervals of stat test TAT be‐tween two departments .Results TAT outlier rates of stat CBC tests ordered by ED and ICU were 2 .4% and 15 .1% ,and that of stat biochemical profiles ordered by ED and ICU were 12 .3% and 24 .5% ,respectively .there were no significant differences in mean times between order‐to‐receipt of stat CBC tests and biochemical profiles ordered by ED and collection‐to‐receipt of stat CBC tests and biochemical profiles ordered by ICU [(11 .2 ± 4 .0) min vs .(11 .2 ± 4 .5) min ,P>0 .05 ;(13 .2 ± 14 .1)min vs .(13 .8 ± 9 .8) min ,P>0 .05] .ED had significantly shorter mean time of receipt‐to‐report than ICU for stat CBC tests and biochemical profile [(5 .8 ± 4 .4) min vs .(19 .3 ± 12 .5) min ,P0 .01] .The TAT mean times of stat CBC tests and biochemical profiles ordered by ED were shorter than those ordered by ICU [(17 .0 ± 6 .2) min vs .(30 .5 ± 14 .9) min ,P<0 .01 ;(46 .9 ± 17 .2) min vs .(49 .3 ± 16 .5) min ,P<0 .01] .Conclusion The ED TATs for CBC tests and biochemical pro‐files are reasonably set ,and each interval of the ED TATs is well controlled .The ICU TATs for CBCs and biochemical profiles should be reset ,and the process of stat test for ICU should be optimized .

Influence of Gross or Microscopic Hematuria on BTA Stat Test Result in the Detection of Bladder Cancer / 대한비뇨기과학회지

PURPOSE: We prospectively evaluated the influence of gross or microscopic hematuria on the BTA stat test result in the detection of bladder cancer. MATERIALS AND METHODS: Urinalysis, cytology and BTA stat test were performed simultaneously with the single voided fresh urine samples from 107 subjects in a blinded fashion. Subjects were divided into 4 groups according to the presence or absence of gross or microscopic hematuria and the influence of hematuria on the result of BTA stat test was evaluated. The sensitivity and specificity of the BTA stat test were compared to those of urine cytology. RESULTS: Overall sensitivity and specificity of BTA stat test for the detection of bladder cancer were 74.1% and 51.3%, respectively and those of urine cytology were 37% and 100%, respectively. In patients with genitourinary disease other than bladder cancer, false-positive rate of BTA stat test was 50%. In patients without bladder cancer but with gross hematuria, false-positive rate of BTA stat test was 71.4%. On univariate analysis gross hematuria and the presence of bladder cancer affected the BTA stat test result significantly. However, on multivariate analysis the presence of gross hematuria only affected the BTA stat test result significantly. CONCLUSIONS: The BTA stat test was more sensitive but less specific than voided urine cytology and had a high false-positive rate, especially in cases with gross hematuria. These results offset the advantages of the BTA stat test in the detection of bladder cancer.

Evaluation of Appropriateness of STAT Tests / 대한임상병리학회지

BACKGROUND: Apart from devaluing the basic skills of history taking and clinical examinations, the indiscriminate use of STAT tests is increasing in hospital practice. The purpose of this study is to evaluate the appropriateness of the STAT test requests in a tertiary care teaching university hospital. METHODS: We assessed the reasons for the STAT test requests on 644 patients (inpatients 338, emergency room patients 215, and outpatients 91), totaling 1,681 requests, during a 2 week period (between August 8 to 22, 1996) by discussing with the clinicians and nurses and/or reviewing the patient's records. RESULTS: Of 1,681 requests, 779 (46.3%) were considered inappropriate according to the criteria used to define categories. Inappropriate requests were detected in 45.1% (265/588) in wards, 49.0% (446/910) in the emergency room, and 37.2% (68/183) in the out patient department. The frequency of requests during the day showed two peaks: the first between 10 and 11 a.m., and the second between 3 and 4 p.m., which appears to indicate that the STAT tests are often requested for the convenience of the physician rather than true need of the patients. CONCLUSIONS: Many STAT tests are requested for reasons other than true emergencies. Inconsiderate, wasteful, and disruptive STAT test requests imposed an extra burden on the laboratory and resulted in a delay of reports on other true STAT or routine tests. Strategies to reduce the number of inappropriate STAT tests should be established in order to reserve the emergency service for situations of true need.