YEŞİM GÜVENÇ DEMİRAĞCI, FATMA TANELİ, Ece ONUR, ZEKİ ARI, BEYHAN CENGİZ ÖZYURT, HABİB ÖZDEMİR, İsmail TAŞTAN

Acil Serviste Li-Heparinli Tüp Kullanımı ve Yenilenen Acil Test Panelinin Troponin I Sonuç Verme Süresi Üzerine Etkisi

GİRİŞ ve AMAÇ: Acil servisten istenen troponin I testi sonuç verme süresini (TAT) kısaltmak amacıyla laboratuvarımız iş akışında serum yerine plazma örnek tipi değişikliği ve acil test istem panelinin yenilenmesi gibi süreç iyileştirme düzenlemeleri yapılmıştır. Çalışmamızda yapılan değişikliklerin; düzenleme öncesi ile düzenleme sonrası kısa ve uzun dönemler arasında troponin I TAT üzerine etkisinin karşılaştırılması amaçlanmıştır.YÖNTEM ve GEREÇLER: Çalışmamızda düzenleme öncesi üç ay (n=1852) ve düzenleme sonrası üç aylık kısa dönem (n=1278) ve üç aylık uzun dönemde (n=2786) laboratuvarımıza gelen acil servis troponin I testi TAT süreleri karşılaştırılmıştır. Veriler Laboratuvar Bilgi Sistemi'nden geriye dönük olarak elde edilmiştir. BULGULAR: Troponin I TAT süreleri karşılaştırıldığında; düzenleme öncesi ile düzenleme sonrası kısa dönem (48±20 vs 43± 16 dakika, p=0.0007) ve düzenleme öncesi ile düzenleme sonrası uzun dönem (48±20 vs 35±12 dakika, p=0.0002) arasında istatistiksel olarak anlamlı azalma bulunmuştur. Düzenleme sonrası kısa dönem ile düzenleme sonrası uzun dönem TAT süreleri arasında da (43± 16 vs 35±12 dakika, p=0.0004) istatistiksel olarak anlamlı kısalma tespit edilmiştir. Hedef süreyi aşan örnek yüzdesinde; düzenleme öncesi ile düzenleme sonrası kısa dönem (p=0.001) ve düzenleme öncesi ile düzenleme sonrası uzun dönem (p<0.001) arasında istatistiksel olarak anlamlı azalma bulunmuştur.TARTIŞMA ve SONUÇ: Acil servis troponin I testinin analizinde Li-heparinli plazma kullanımına geçilmesi, ve acil servis test panelinin yenilenmesi gibi süreç geliştirme düzenlemeleriyle ile troponin I TAT kısalmış, hedeflenen acil TAT ‘ı aşan örnek sayısı anlamlı olarak azalmış ve acil servis hizmet kalitesi artmıştır.

Anahtar Kelimeler:

süreç değerlendirme, kalite iyileşmesi, kalite belirteçleri, plazma, troponin I

The Effect of Li-Heparin Plasma Preference In Emergency Unit And New Emergency Test Request Panel On Troponin I Turnaround Time

INTRODUCTION: Serum to plasma sample type change and renewal of the emergency test request panel were carried out in our laboratory workflow to decrease the turnaround time (TAT) of the troponin I test requested from the emergency department. The aim of the present study was to compare the TATs of the troponin I test between the short and long term periods before and after the workflow arrangements.METHODS: In our study, TAT times of the emergency service troponin I test were compared in the study groups as; three months before the organization (n=1852), short-term post organization (n=1278) and long-term post organization (n=2786) at three months intervals. The data were obtained retrospectively from the Laboratory Information System.RESULTS: Troponin I TAT times were compared between the study groups and statistically significant decreases were observed; before and after short-term workflow organization (48±20 vs 43±16 minutes, p=0.0007) before and after long-term workflow organization (48±20 vs 35±12 minutes, p=0.0002). The percentages of the troponin I values exceeding the target TAT emergency periods were also found to be significantly decreased between the study groups; before and after short-term workflow organization (p=0.001) before and after long-term workflow organization (p<0.001).DISCUSSION AND CONCLUSION: The use of Li-heparin plasma instead of serum as a sample type and the application of new emergency test panel significantly shortened the TAT of troponin I results and the number troponin I specimen exceeding the troponin I target TAT were also found to be significantly decreased and the laboratory quality emergency unit was increased.

Keywords:

process assessment, quality improvement, quality indicators, plasma, troponin I,

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