临床用血闭环式管理模式的建立与运行实效  

A closed-loop clinical blood management model: establishment and operation analysis

作　　者：姚洁[1] 王欣[2] 姚远[3] 沈芳妮[2] 陈惠欣[1] 梁海燕[1] 赵正[4] 李春华[1] YAO Jie;WANG Xin;YAO Yuan;SHEN Fangni;CHEN Huixin;LIANG Haiyan;ZHAO Zheng;LI Chunhua(Department of BloodTransfusion;Medical Service;Information Center;Capital Medical University, Xuanwu Hospital, Capital University of Medical Sciences ,Beijing , 100053, China.)

机构地区：[1]首都医科大学宣武医院输血科,北京100053 [2]首都医科大学宣武医院医务处,北京100053 [3]首都医科大学宣武医院信息中心,北京100053 [4]首都医科大学临床医学系,北京100053

出　　处：《中国输血杂志》2018年第2期208-211,共4页Chinese Journal of Blood Transfusion

基　　金：2017年北京市医管局医疗质量管理专题研究项目;2017年首都医科大学本科生创新项目(XSKY2017126)

摘　　要：目的建立医院可以对临床用血全过程实时监控的闭环式管理模式。方法由医院临床用血管理委员会（临床用血管委会）整合医院信息系统、电子病历系统、实验室信息系统、移动护理系统、手术麻醉系统、输血管理系统以及临床用血评估系统,输血科应用信息化手段管理输血申请与审核、库存预警、血清学相容性检测、血液发放、临床输血、自体输血管理、输血不良事件上报、申请用血评估以及输血后评价各个步骤,使全院的临床用血全过程处于临床用血管委会和输血科实时监控的闭环管理中。结果临床用血过程闭环管理实施前后3年的平均数据显示住院患者人数增加15.11%的情况下,临床用血总量减少4.44%,人均用血量减少14.64%;手术台数增加14.09%的情况下,手术用红细胞减少18.45%,手术科室自体血输血比例增加9.02%;临床用血过程闭环管理规范医院临床科室的用血行为,规范了输血科的用血管理,减少了手工录入环节导致的人为误差,保障了临床用血信息的准确性,提高了临床用血的安全性、可控性。结论临床用血闭环式管理有效提高了医院临床用血安全性、可控性会和适用性。Objective To establish a hospital closed-loop management model enabling real-time monitoring over the entireprocess of clinical blood use. Methods The utilization of numerous sub system modules in the hospital was performed under the guidance of the clinical blood use committee,including the general informatics system,electronic medical record system,laboratory information system,mobile nursing system,surgical anesthesia system,blood transfusion management system,clinical blood use assessment system,the transfusion department application information,inventory early warning,serological compatibility testing,blood delivery,clinical blood transfusion,autologous blood transfusion management,blood transfusion adverse events,application of blood assessment,and post-transfusion evaluation procedures. Thus,we acquired theclosed-loop management of real-time monitoring. Results The 3-year average datapost the implementation of the system showed an increasein hospitalized patients by 15. 11%withthe total amount of clinical blood usereduced by 4. 44%.The average blood consumptionper patientdecreased by 14. 64%,and the number of operations performedincreased by 14. 09%. The Red blood cell use for surgery was reduced by 18. 45%,and the proportion of autologous blood transfusion in the operating department increased by 9. 02%; This particular systemstandardized the blood useand management in allthe concerned departments and reduced human error,which ultimately ensured the clinical blood information accuracy and improved clinical blood use insafety and controllability.Conclusion The closed-loop clinical bloodmanagement system has effectively improved the safety,controllability,and applicability of the clinical blood use in our hospital.

关 键 词：临床用血 闭环式管理 输血管理系统 实时监控 

分 类 号：R457.1[医药卫生—治疗学] C931.6[医药卫生—临床医学]