持续质量改进在降低儿科血标本溶血中的应用  

Application of Continuous Quality Improvement in Reducing Blood Specimen Hemolysis in Pediatric

作　　者：潘红梅[1] 杨晓晴[1] 谷卫芬 查剑凤 陈剑萍[1] 

机构地区：[1]海盐县人民医院护理部,浙江海盐314300

出　　处：《解放军护理杂志》2011年第13期55-57,共3页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的通过持续质量改进(continuous quality improvement,CQI)降低儿科血标本溶血的发生率,提高检验结果的准确性。方法在全面分析标本溶血原因的基础上,自2010年1月起将持续质量改进的方法应用于儿科血标本采集,具体方法包括成立质量控制小组、建立标本采集指南、增强血标本管理意识、强调采血时的注意点、调整采血时间、改进采血流程等。比较2009年7-12月(实施CQI前)和2010年1-6月(实施CQI后)采集的1 641份和1 788份血标本溶血的发生率,并调查400例患儿家长对护士采血技术和服务态度的满意度。结果实施CQI措施后6个月,血标本的溶血发生率明显下降(P<0.01),而且在各年龄段比较中差异均有统计学意义(P<0.05或P<0.01),其中血标本重度以上溶血的发生率从CQI实施前的25.84%下降到6.49%;患者对护士服务态度满意度由90.75%上升到98.50%,技术满意度由88.50%上升到96.75%。结论实施CQI提高了儿科护士的综合能力、增强了科室的凝聚力,能有效降低血标本的溶血发生率,提高患儿家长的满意度。Objective To reduce the incidence of pediatric blood specimen hemolysis and improve the accuracy of test results through continuous quality improvement（CQI）.Methods Based on a comprehensive analysis of specimen hemolysis,the CQI was applied in the pediatric blood specimen collection since January 2010 including the establishment of quality control groups,the establishment of specimen collection guidelines,enhanced management awareness of blood samples,emphasis on the key points In blood collection,adjustmnetof of the blood collection time,improvement in blood collecting flow.The incidents of blood specimen hemolysis were compared between 1641 blood specimens during July and December 2009 before CQI and 1788 blood specimens during January and June 2010 before CQI.The satisfaction of 400 patients＇ families were investigated on the blood collecing technique and service attitude of nurses.Results The incident of blood specimen hemolysis was significantly decreased after six months＇ quality improvement measures.Significant differences were observed in every age groups（P〈0.05 or P〈0.01）.The incidence of severe blood specimen hemolysis,patients＇ satisfaction on the service attitude of nurses and technical satisfaction weredecreased from 25.84% to 6.49%,90.75% to 98.50% and 88.50% to 96.75%,respectively.Conclusion Implementation of CQI improves the comprehensive capacity of pediatric nurses,enhances the cohesion of the department,effectively reduces the incidence of hemolysis of blood specimens and improves the satisfaction of patients＇ families.

关 键 词：持续质量改进 血液标本 溶血 质量管理 护理 

分 类 号：R197.323[医药卫生—卫生事业管理]