智慧型闭环移动护理管理系统在临床用血质量管理中的应用  

Application of intelligent closed-loop mobile nursing management system in quality management of blood transfusion

作　　者：张业玲[1] 卜晓佳 张景莲[1] 邵常岩 张树超[2] ZHANG Yeling;BU Xiaojia;ZHANG Jinglian;SHAO Changyan;ZHANG Shuchao(Department of Hematology,The Affiliated Hospital of Qingdao University,Qingdao 266003,China;Department of Blood Transfusion,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院血液内科,山东青岛266003 [2]青岛大学附属医院输血科,山东青岛266003

出　　处：《中国输血杂志》2021年第4期420-423,共4页Chinese Journal of Blood Transfusion

基　　金：山东省重点研发计划(2017GSF18128)。

摘　　要：目的探讨智慧型闭环移动护理管理系统在临床用血质量管理中的应用效果。方法将青岛大学附属医院信息管理系统(7.0.2)与输血科(血库)信息管理系统(6.4.0.56)整合,优化输血护理流程,实现输血智慧化闭环护理管理。设对照组:通过HIS选取2017年1月~12月(闭环管理实施前)入住本院血液内科行输血治疗的患者789人;观察组:2018年1月~12月(闭环管理实施后)入住本院血液内科行输血治疗的患者836人。采用自行设计的输血规范管理查检表,规范执行条目数为分子、查检总条目数为分母得出规范执行率。对闭环管理实施前后血标本采集规范查对率、取血后<30 min输注率、床旁输血双人核查执行率、输血巡视规范率、<4 h红细胞输注完毕率及输血护理记录规范率做比较,采用χ2检验或Fisher精确概率法做统计分析,评价用血质量管理改进效率。采用目的抽样法,抽取涉及输血的临床科室(血液内科、心外科、手术室、综合ICU)护士长共8名做半结构式访谈,访谈围绕智慧型闭环移动护理信息系统在临床用血质量管理中的效果展开,对访谈结果做分析。结果观察组与对照组床旁输血双人核查执行率为100%(836/836)vs 97.72%(771/789),血标本采集规范查对率99.04%(828/836)vs 97.34%(768/789)、取血后<30 min输注率97.97%(819/836)vs 95.06%(750/789)、输血巡视规范率99.28%(830/836)vs 94.93%(712/789)、<4 h红细胞输注完毕率99.16%(829/836)vs 97.47%(769/789)及输血护理记录规范率100%(836/836)vs 89.73%(708/789)(P<0.05);输血质量控制记录、质控结果汇总、质控结果反馈耗时明显缩短。结论智慧型闭环移动护理管理系统应用于临床用血质量管理,有效提升了输血(时间)效率和护理质量,有助于确保临床用血安全。Objective To explore the effect of intelligent closed-loop mobile nursing management system in quality management of blood transfusion. Methods The mobile nursing system and the cold chain management system of our hospital were integrated to realize intelligent closed-loop management of blood transfusion. After consulting medical records, 789 blood recipients, admitted to the Department of Hematology of our hospital from January to December 2017(before the implementation of closed-loop management), were selected as the control group, and 836 blood recipients, admitted during January to December 2018(after the implementation of closed-loop management), were selected as the observation group. A self-designed blood transfusion standard management checklist was adopted, with the number of standard execution items as the numerator and the total number of checked items as the denominator to obtain the standard implementation rate. The checking rate of blood sample collection, blood transfusion rate within 30 min after blood issuing, the execution rate of double check specification and inspection specification, the completion rate of RBCs transfusion within 4 h and qualified rate of blood transfusion nursing record before and after the implementation of closed-loop management were compared by chi-square test or Fisher’s exact probability method to evaluate the efficacy of blood quality management improvement. A total of 8 head nurses from clinical departments(Hematology Department, Cardiac Surgery Department, Operating Room, Comprehensive ICU) involved in blood transfusion were selected for semi-structured interviews. The interviews focused on the effect of intelligent closed-loop mobile nursing information system in quality management of clinical blood use, and the results of the interviews were analyzed. Results The double check execution rate of blood transfusion, the checking rate of blood sample collection specification, the transfusion rate within 30 min after blood issuing, the execution rate of blood transfusi

关 键 词：输血护理 移动护理管理系统 智慧型闭环管理 临床用血安全 输血质量管理 

分 类 号：R457.1[医药卫生—治疗学]