专家建议减少住院患者的检验次数
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By LabMedica International staff writers Posted on 21 Dec 2017 |
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图像：收集人血样做检验；过多的检验可能引起医院获得性贫血（图片蒙Rebecca Zeffert惠赐）。
住院患者的日常化验反映了临床业务的浪费，它威胁着医疗护理的价值。大量职业社团主张把以临床稳定性为名的重复化验认定为无价值医疗。
过多的静脉切开术可能导致医院获得性贫血，增加开支，引起不必要的下游检验和手术。努力降低化验频度会提高病人满意度，减少成本，且不会对病人预后造成不良影响。
美国马里兰州巴尔的摩市约翰霍普金斯大学医学院的内科医师与北美其它几家单位的专家编制并草拟了一份基于经验的质量改进计划，以减少住院患者的重复化验。作者引用的各项研究都显示，一线医疗工作者化验的请求量减少了8%到19%，作者报告说，每年节省的费用范围是60万美元到200万美元。
专家建议，有必要设计以数据为支撑的全医院培训计划，共同勾勒和标准化最佳实践。确立要减少的化验请求的数量目标，向送检医师提供即时反馈，显示他们个人送检的模式，他们因此能意识到自己的行为不符合已得到一致认可的标准。也可以修改用于请求化验的电子系统的程序，限制“预订”化验的数量，同时留意是否有更好的送检原因，而不是机械地天天送检。
迄今已在多家机构部署了大量干预措施，但没有一个标准方法。医疗工作者和行政领导应该仔细制定行动策略，并优化工作方式，以减少每天的化验次数。已发表的论文显示，减少重复的日常化验不会导致漏诊或增加再次入院的数量。
该研究的论文发表于2017年10月16日的《JAMA》杂志《内科》分册。领衔作者、第三年的内科住院医师Kevin P. Eaton博士说：“抽血次数过多可能耗尽病人的血红蛋白，这又经常导致重复化验。有人估计近20%的住院患者会得中度到重度的医院获得性贫血。如此反复会给病人带来更多不必要的检验、干预和花销。”
Related Links:
约翰霍普金斯大学医学院
过多的静脉切开术可能导致医院获得性贫血，增加开支，引起不必要的下游检验和手术。努力降低化验频度会提高病人满意度，减少成本，且不会对病人预后造成不良影响。
美国马里兰州巴尔的摩市约翰霍普金斯大学医学院的内科医师与北美其它几家单位的专家编制并草拟了一份基于经验的质量改进计划，以减少住院患者的重复化验。作者引用的各项研究都显示，一线医疗工作者化验的请求量减少了8%到19%，作者报告说，每年节省的费用范围是60万美元到200万美元。
专家建议，有必要设计以数据为支撑的全医院培训计划，共同勾勒和标准化最佳实践。确立要减少的化验请求的数量目标，向送检医师提供即时反馈，显示他们个人送检的模式，他们因此能意识到自己的行为不符合已得到一致认可的标准。也可以修改用于请求化验的电子系统的程序，限制“预订”化验的数量，同时留意是否有更好的送检原因，而不是机械地天天送检。
迄今已在多家机构部署了大量干预措施，但没有一个标准方法。医疗工作者和行政领导应该仔细制定行动策略，并优化工作方式，以减少每天的化验次数。已发表的论文显示，减少重复的日常化验不会导致漏诊或增加再次入院的数量。
该研究的论文发表于2017年10月16日的《JAMA》杂志《内科》分册。领衔作者、第三年的内科住院医师Kevin P. Eaton博士说：“抽血次数过多可能耗尽病人的血红蛋白，这又经常导致重复化验。有人估计近20%的住院患者会得中度到重度的医院获得性贫血。如此反复会给病人带来更多不必要的检验、干预和花销。”
Related Links:
约翰霍普金斯大学医学院
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