핵의학 검체검사의 경고치 보고(Critical Value Report)에 관한 실태 조사 보고

다국어 초록 (Multilingual Abstract)

Purpose: Critical value report (CVR) are intended to prevent delays in diagnosis and treatment, as results outside the reference range can cause serious harm to patients. After conducting a survey on the status of warning value reporting in each institution's laboratory that performs nuclear medicine specimen testing, the level of preparedness for patient safety was identified, and the category, guidelines, and reporting system for warning value reporting tests were checked and applied effectively and objectively. The purpose of this study was to share these methods and suggest policies and plans for improvement plans. Materials and Methods: A questionnaire related to warning value reporting was prepared with 20 questions using Excel and sent by e-mail to 46 medical institutions and trusted institutions undergoing domestic nuclear medicine specimen test certification review from 2024.03.18 to 2024.4.09. Based on the contents of the questionnaire, the setting of warning value reporting items for each institution and the overall trend of work were analyzed using distribution maps, etc. Results: Of the 46 medical institutions, 32 responded via e-mail, showing a response rate of 69.5% of the 22 items. The most common warning value reporting setting item was FreeT4 (N=8), followed by HAVIgM (N=7), neonatal TSH, HBcIgM (N=6), Cyclosporine (N=4), TSH, PTH, PSA, and neonatal FT4 (N =3), Thyroglobulin (N=2), and other HCVAb, T3, AFP, ACTH, CA125, CA19-9, CA15-3, Cortisol, Aldosterone, HBsAg, AB(++), Prolactin (N= 1). It seven organizations (24.1%) set warning value reporting items due to the request from the prescription department and 19 organizations (65.5%) set their own items in preparation for each certification audit. Conclusion: The reason why each institution that conducts nuclear medicine specimen testing tends to have a high tendency to set its own warning value reporting items is not because of the demands of the prescribing department or clinician, but because it is included as an important factor in each certification review item, so the items are required by necessity. It was found that among the total responses, 6 organizations (18.7%) do not report warning values, which appears to be determined by each organization's situation. If each institution recognizes the importance of warning value reporting and sets the items and scope, it is recommended to have a warning value reporting monitoring system. Taking into account the possibility of changes in the patient population, etc., it is recommended that the prescribing department, clinicians, and quality control managers within the department establish standards. We suggest that arrangements be reviewed regularly. It is believed that if warning value reporting items and standard values are set considering the importance of patient safety, etc. , it can contribute to promoting the importance of nuclear medicine specimen testing and increasing reliability.