Year of Publication

2018

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Sharon Lock

Clinical Mentor

Dr. Michelle Pendleton

Committee Member

Dr. Elizabeth Tovar

Abstract

PURPOSE: The purpose of this project was to perform a needs assessment to determine if there was a delay in addressing abnormal lab results. The objectives were: 1) to determine the amount of time it takes for providers to address abnormal lab results in the ambulatory setting at an ambulatory setting within a Southeast Health Care System and 2) evaluate the alert and order set system for abnormal lab results of thyroid stimulating hormone, lipid panels, and hemoglobin A1C.

METHODS: A retrospective chart review was performed to determine the time it takes for primary care providers to address or follow up on abnormal lab results in the primary care setting. The timeframe was from February 1, 2017 to July 1, 2017. The Healthcare System IT department randomly selected 100 charts from all ambulatory care visits for review from February 1, 2017 to July 1, 2017 who met the inclusion criteria. Inclusion criteria were patients 18 years of age and older with an ICD-10 code for hypothyroidism- E03.9, hyperlipidemia- E78.5, or type 2 diabetes - E11.65 with correlating lab results. Charts were reviewed for date and time lab was obtained, the lab results, the date and time lab results were documented in the chart, the date and time the provider acknowledged the results and what the provider did to address the results.

RESULTS: The median time it took providers to follow-up with abnormal lab results was thirty-two hours. The seventy-fifth interquartile range was 110 hours and the twenty-fifth interquartile range was fifteen hours. This means that seventy-five percent of patients were notified between fifteen and 110 hours. The goal time for the organization’s abnormal lab follow-up in the primary care setting is forty-eight hours.

CONCLUSION: There was no delay in abnormal lab follow-up in the ambulatory care setting. The abnormal labs reviewed were under the time the organization requires for follow-up.

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