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CSF xanthochromia analysis takes longer following centralisation of the laboratories testing samples – how can we improve the time to result?

Lumbar puncture is an essential tool for excluding subarachnoid haemorrhage. In August 2012, the laboratory at which cerebrospinal fluid (CSF) is analysed for xanthochromia in Lanarkshire was centralised at Hairmyres (East Kilbride, UK). Prior to this, each of the three hospitals analysed their own...

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Autores principales: Martin, Sean, Page, Melanie, Godber, Ian, McGregor, Calum
Formato: Online Artículo Texto
Lenguaje:English
Publicado: British Publishing Group 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4663835/
https://www.ncbi.nlm.nih.gov/pubmed/26734223
http://dx.doi.org/10.1136/bmjquality.u202450.w1177
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author Martin, Sean
Page, Melanie
Godber, Ian
McGregor, Calum
author_facet Martin, Sean
Page, Melanie
Godber, Ian
McGregor, Calum
author_sort Martin, Sean
collection PubMed
description Lumbar puncture is an essential tool for excluding subarachnoid haemorrhage. In August 2012, the laboratory at which cerebrospinal fluid (CSF) is analysed for xanthochromia in Lanarkshire was centralised at Hairmyres (East Kilbride, UK). Prior to this, each of the three hospitals analysed their own specimens. We aim to assess whether or not the change in xanthochromia processing has resulted in diagnostic delay at Wishaw General Hospital in the assessment of CT negative possible subarachnoid haemorrhage. We subsequently assessed the impact of a strategy to minimise any delay, i.e. increasing laboratory processing hours. Patients undergoing CSF analysis for xanthochromia were identified directly from the laboratory database. Time of lumbar puncture, and time of xanthochromia results were obtained from the hospital's laboratory computer system. Data were analysed using a commercially available statistical software programme (Microsoft Excel). Audit was repeated after the change to a centralised laboratory, and again following the increased laboratory working hours. Mean time from lumbar puncture to availability of xanthochromia result was significantly longer following the laboratory change (20.8±3.5 hours post [n=35] vs. 12.5±3.0 pre, p=0.01 [n=17]). However, following a change in the laboratory's practice, there was no improvement (19.8±3.4 hours post practice change [n=35]), and this remained significantly longer when compared to the original laboratory set-up (p=0.025). The change in laboratory processing CSF samples for xanthochromia in Lanarkshire resulted in a significant delay in analysing the samples. Attempts by the laboratory to extend processing hours did not make any significant improvement, but having expanded our knowledge of the issues, further measures are now planned to minimise delays in the future. Centralisation of laboratory services for CSF analysis, whilst cheaper, may impact negatively on clinical care.
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spelling pubmed-46638352016-01-05 CSF xanthochromia analysis takes longer following centralisation of the laboratories testing samples – how can we improve the time to result? Martin, Sean Page, Melanie Godber, Ian McGregor, Calum BMJ Qual Improv Rep BMJ Quality Improvement Programme Lumbar puncture is an essential tool for excluding subarachnoid haemorrhage. In August 2012, the laboratory at which cerebrospinal fluid (CSF) is analysed for xanthochromia in Lanarkshire was centralised at Hairmyres (East Kilbride, UK). Prior to this, each of the three hospitals analysed their own specimens. We aim to assess whether or not the change in xanthochromia processing has resulted in diagnostic delay at Wishaw General Hospital in the assessment of CT negative possible subarachnoid haemorrhage. We subsequently assessed the impact of a strategy to minimise any delay, i.e. increasing laboratory processing hours. Patients undergoing CSF analysis for xanthochromia were identified directly from the laboratory database. Time of lumbar puncture, and time of xanthochromia results were obtained from the hospital's laboratory computer system. Data were analysed using a commercially available statistical software programme (Microsoft Excel). Audit was repeated after the change to a centralised laboratory, and again following the increased laboratory working hours. Mean time from lumbar puncture to availability of xanthochromia result was significantly longer following the laboratory change (20.8±3.5 hours post [n=35] vs. 12.5±3.0 pre, p=0.01 [n=17]). However, following a change in the laboratory's practice, there was no improvement (19.8±3.4 hours post practice change [n=35]), and this remained significantly longer when compared to the original laboratory set-up (p=0.025). The change in laboratory processing CSF samples for xanthochromia in Lanarkshire resulted in a significant delay in analysing the samples. Attempts by the laboratory to extend processing hours did not make any significant improvement, but having expanded our knowledge of the issues, further measures are now planned to minimise delays in the future. Centralisation of laboratory services for CSF analysis, whilst cheaper, may impact negatively on clinical care. British Publishing Group 2013-10-25 /pmc/articles/PMC4663835/ /pubmed/26734223 http://dx.doi.org/10.1136/bmjquality.u202450.w1177 Text en © 2013, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ http://creativecommons.org/licenses/by-nc/2.0/legalcode
spellingShingle BMJ Quality Improvement Programme
Martin, Sean
Page, Melanie
Godber, Ian
McGregor, Calum
CSF xanthochromia analysis takes longer following centralisation of the laboratories testing samples – how can we improve the time to result?
title CSF xanthochromia analysis takes longer following centralisation of the laboratories testing samples – how can we improve the time to result?
title_full CSF xanthochromia analysis takes longer following centralisation of the laboratories testing samples – how can we improve the time to result?
title_fullStr CSF xanthochromia analysis takes longer following centralisation of the laboratories testing samples – how can we improve the time to result?
title_full_unstemmed CSF xanthochromia analysis takes longer following centralisation of the laboratories testing samples – how can we improve the time to result?
title_short CSF xanthochromia analysis takes longer following centralisation of the laboratories testing samples – how can we improve the time to result?
title_sort csf xanthochromia analysis takes longer following centralisation of the laboratories testing samples – how can we improve the time to result?
topic BMJ Quality Improvement Programme
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4663835/
https://www.ncbi.nlm.nih.gov/pubmed/26734223
http://dx.doi.org/10.1136/bmjquality.u202450.w1177
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