输血科拒收不合格标本原因分析与持续改进

发布时间：2018-04-23 17:37

本文选题：输血标本 + 持续改进　；参考：《中国输血杂志》2017年01期

【摘要】：目的对2013-2015年输血科拒收的不合格标本原因分析总结,提出方案,不断持续改进,为临床提供安全的血液输注。方法分别列出2013-2015年各项拒收不合格标本原因,计算各拒收原因占百分数比例,统计χ2值与P值,对拒收不合格标本原因进行分析总结,实施持续改进方案。结果 2013-2015年不合格标本数分别为251例(占2.53%)、185例(占1.39%)、157例(占0.91%),χ2=116.3,P0.05,差异有统计学意义。原因分别为非医护人员送血标本、血标本采集管用错、血标本采集管无标签或填写不清、血标本量3 m L(儿科除外)、血标本被稀释、血标本溶血(溶血疾病除外)、血标本经肝素或大分子物质治疗过、申请单血型漏填或填错、申请单输血史及妊娠史漏填或填错、申请单Hb、Hct及输血前4项漏填或填错、申请单血液品种及血量漏填或填错、申请单预定用血日期漏填或填错、申请单两级医师签字漏填或填错。总共13项原因,前11项原因百分比都有逐年下降趋势,只有最后两项百分比却逐年上升。结论重视输血科标本接受核对问题,增强对护理人员"输血采集血标本的管理制度"的培训,输血科工作人员及临床送检标本人员严格执行"输血标本验收核对制度",从而保证临床输血的安全性。
[Abstract]:Objective to analyze and summarize the causes of rejected substandard specimens in blood transfusion department from 2013 to 2015, and put forward a plan for continuous improvement in order to provide safe blood transfusion for clinical use. Methods the causes of rejection of unqualified specimens in 2013-2015 were listed respectively. The percentage of the reasons of rejection was calculated. The statistical 蠂 ~ 2 value and P value were used to analyze and summarize the reasons for rejection of unqualified specimens and to carry out the continuous improvement scheme. The reasons were that the blood samples were given by non-medical personnel, the blood samples were collected correctly, the blood collection tubes were not labelled or filled in clearly, and the blood sample volume was 3 mL (except paediatrics, the blood samples were diluted. The blood type and blood volume of the application form is missing or wrong, the application form is intended to be filled in with the blood date or wrong, and the application form is signed by the doctor of two levels. In total, the percentage of the first 11 reasons decreased year by year, but only the last two ones increased year by year. Conclusion attention should be paid to the problem of receiving and checking blood samples in blood transfusion department, and the training of nursing staff on "management system of blood transfusion collection" should be strengthened. In order to ensure the safety of clinical blood transfusion, the staff of blood transfusion department and the personnel of clinical examination and examination strictly carry out the acceptance check system of blood transfusion specimen.
【作者单位】：昆明市第一人民医院输血科;
【分类号】：R457.1;R197.323

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