某院不合格标本原因分析及对策方案  

Analysis of causes and countermeasure of unqualified specimen in a hospital

作　　者：林一民[1] 陆芸瑶 蒋焦 吴立翔[1] 

机构地区：[1]重庆市肿瘤研究所临床检验科,400030

出　　处：《检验医学与临床》2016年第22期3158-3160,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨不合格标本发生的原因及解决方案,确保分析前标本的质量。方法回顾性分析该院标本采集质量改进前后检验科不合格标本情况,对不合格的原因进行分析,并提出改进措施。结果 300 657例送检标本中不合格标本送检总数1 292例,总不合格率0.43%。不合格原因前5位分别是:标本不足(或空管)31.0%、凝固24.5%、溶血16.2%、标本与抗凝剂比例错误9.5%、条码信息不全或错误9.0%。与标本采集质量改进前比较,质量改进后标本不合格率由0.54%下降到0.33%,差异有统计学意义(P<0.05),有9个科室标本不合格率下降显著(P<0.05)。结论增强工作人员责任心,严格执行标本拒收管理,加强与临床工作人员沟通及培训,降低标本不合格率,是提高分析前质量的关键。Objective To investigate the causes and the solutions of unqualified specimen,and to in ensure the quality of the specimen before analysis.Methods Unqualified specimens of clinical laboratory were retrospectively analyzed before and after the quality improvement of specimen collection in the hospital.Causes of the unqualified specimens were analyzed as well.Results Totally 1 292 cases of unqualified specimen were detected out in 300 657 samples.And the total unqualified rate was 0.43%.The top 5 reasons for unqualified specimen were as following：insufficient samples（or blank pipe）accounted for 31.0%,solidification accounted for 24.5%,hemolysis accounted for 16.2%,samples with anticoagulant ratio error accounted for 9.5% and bar code information not completed or false accounted for 9.0%.Compared with before the quality improvement of specimen collection,unqualified rate of specimen decreased from 0.54%to 0.33%,difference was statistically significant after the quality improvement of specimen collection（P〈0.05）.In addition,unqualified rates in nine departments were all significantly lower than before（P〈0.05）.Conclusion It is important to improve the quality of former analysis by enhancing the sense of responsibility,carrying out strict samples rejection management,strengthening the communication and training with clinical workers and reducing the unqualified rates.

关 键 词：不合格标本 不合格率 原因分析 对策 

分 类 号：R512.4[医药卫生—内科学]