3. NOTIFICATION OF CRITICAL
LABORATORY RESULT
• An important aspect of patient safety.
• Hospital accreditors are placing increased emphasis
on the timeliness with which critical laboratory
results are reported to caregivers.
• Failure to report critical lab results in a timely and
reliable way is a threat to patient safety and
healthcare quality.
• For Accreditation purpose, all Labs must have a list of
critical limits, formulate notification procedures,
document critical results and notify clinicians
immediately.
4. DEFINITIONS
• Critical result
• A test result that was generated by the chemistry or hematology
section of a laboratory, that concerned an inpatient or emergency
department patient and that met a laboratory’s local threshold for a
critical result that must be rapidly communicated.
• Critical results are defined as results that, if left untreated, could be life
threatening or place the patient at serious risk
• Physician
A licensed doctor of medicine.
• Licensed caregiver
• A physician, registered nurse or PPP (an individual
the JC considers to be someone who is authorized to take
action on the results or an agent who can immediately notify
someone authorized to take action. )
5. Execution of notification of critical lab results
• Defining lists of critical values to be
communicated
• Identifying who to call.
• Establishing explicit time frame to call.
• Documentation
6. LIST OF CRITICAL LAB TEST
• 10 TESTS
o Serum Potassium
o Serum Na
o RBS
o Hb
o Blood Urea
o Calcium
o Platelet
o PT
o APTT
o Serum amylase
7.
8. MECHANISM OF NOTIFICATION
• Responsibility of MLT.
• Responsibility of licensed caregiver
• Flowchart of communication process
• Documentation
~ laboratory
~ receiving unit
9. RESPONSIBILITY OF MLT
• Check the test request form whether test is in
the list of critical lab result(CLR).
• Perform the test.
• If CLR list, check and validate result. If results
in the critical range, immediately call the unit
requesting test.(Licensed care provider).
• Communicate result to licensed care provider
using read back method.
• Document the process in “Borang Notifikasi
CLR”.
10. RESPONSIBILITY OF LICENSED CARE PROVIDER
• Receive notification from MLT and record
information in “ Borang Penerimaan CLR”.
• Read back result to MLT to confirm correct
result.
• Inform Medical Officer for further actions.
• Collect hardcopy of lab result and filed in
patient’s notes.
11. FLOW CHART FOR NOTIFICATION OF CRITICAL LAB RESULT
Start
MLT receive request for lab test
MLT check whether in the list
of CLR
No
Process as
routine
END
Yes
Process speciment and record
result
2nd
MLT validate result and check
result whether in critical range
No
Record result
and dispatch
to requesting
unit
END
Yes
Inform result to
licensed care
provider & record
in Borang
Notifikasi CLR
12. NOTIFICATION VIA TELEPHONE
• Informer name and designation
• Confirm patient location
• Patient ID : name, IC no, MRN
• Sample date & time
• Test name & result
• Result read back by recipient
• Document recipient name & designation
• Document date & time of notification
13. BORANG NOTIFIKASI CRITICAL LAB RESULT
BIODATA PESAKIT
Nama :
No KP :
MRN :
Unit :
Tarikh ujian :
Jenis ujian :
KEGUNAAN MAKMAL
Tarikh & masa terima specimen :
Tarikh & masa ujian siap :
Validation : Masa :
Peg. :
Masa CLR diberitahu :
UJIAN MAKMAL
1. Nama ujian :
Keputusan :
2. Nama ujian :
Keputusan :
3. Nama ujian :
Keputusan :
4. Nama ujian :
Keputusan :
5. Nama ujian :
Keputusan :
PENERIMAAN CLR
Pegawai yang menerima notifikasi telefon :
Pegawai yang menerima salinan hardcopy CLR :
Tarikh dan masa dispatch keputusan :
Tandatangan MLT yang bertugas :
14. Critical Result 5 Steps Reminder
(MLT)
• Check for any critical result
• Confirm critical result
• Call ward immediately
• Asked for a read-back
• Record the notification
15. FLOWCHART FOR RECEIVING CRITICAL LAB RESULT
Collect hardcopy from lab
and filed in patient’s record
END
Start
SN or PPP receive notification
of CLR from MLT
Record result in Borang Penerimaan
CLR
Notify CLR to Medical Officer
16. RECEIVING CLR
• Information to record :
Patient ID : name, IC No, MRN
Sample date and time
Test and result
Lab staff name
Date & time of notification
Name of recipient
17.
18. LAMPIRAN 5 : BORANG PENERIMAAN CLR
BIODATA PESAKIT
Nama :
No KP :
MRN :
Unit :
Tarikh ujian :
Jenis ujian :
KEGUNAAN UNIT
Tarikh & masa terima CLR:
SN /PPP yang bertugas :
Pegawai yang notifikasi CLR :
UJIAN MAKMAL
1. Nama ujian :
Keputusan :
2. Nama ujian :
Keputusan :
3. Nama ujian :
Keputusan :
4. Nama ujian :
Keputusan :
5. Nama ujian :
Keputusan :
PENERIMAAN CLR
Pegawai yangdispatch hardcopy CLR :
Pegawai yang menerima salinan hardcopy CLR :
Tarikh dan masa terima keputusan :
Tandatangan pegawai yang menerima CLR :
MAKLUMAN KEPADA PEGAWAI PERUBATAN
Pegawai perubatan yang menerima keputusan :
Tarikh dan masa dimaklumkan :
19. Critical Result (WARD)
6 STEPS REMINDER
• Receive Notification Of Critical Results From
Lab
• Read Back Results
• Record Results In The Form
• Inform Dr Immediately
• Get Hard Copy Of Results From Lab
• Attach Results In BHT
