全程输血质量管理在血液标本2次血型鉴定结果不一致中的应用研究  

Application of Comprehensive Quality Management Intervention in the Inconsistent Results of Blood Group Identification

作　　者：徐应芳[1] 黄洁[1] 肖成[1] 李江[1] 李薇[1] 许广芳[1] 谭建玲 XU Ying-fang;HUANG Jie;XIAO Cheng;LI Jiang;LI Wei;XU Guang-fang;TAN Jian-ling(Dept.of Transfusion,The 2nd Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650101,China)

机构地区：[1]昆明医科大学第二附属医院输血科,云南昆明650101

出　　处：《昆明医科大学学报》2021年第11期148-152,共5页Journal of Kunming Medical University

基　　金：昆明医科大学第二附属医院院内基金资助项目(2020yk018)。

摘　　要：目的回顾性分析开展“全程输血质量管理”前后血液标本2次血型鉴定结果不一致情况,调查分析原因,提出改进措施,保障临床用血安全。方法对比分析昆明医科大学第二附属医院开展“全程输血质量管理”前3 a(2015年1月至2017年12月)及后3 a(2018年1月至2020年12月)血液标本2次血型鉴定结果。结果2015年至2020年一共进行120023例2次血型鉴定,共46例血液标本2次血型鉴定结果不一致,发生率0.038%,其中前3 a 34例,发生率为0.061%,后3 a 12例,发生率为0.019%(P<0.05)。调查分析相关因素,在实施“全程输血质量管理”前3 a,患者身份识别错误是主要原因,主要责任人为护士。而在实施“全程输血质量管理”后3 a患者借用他人医保卡信息是主要原因,主要责任人为患者。结论通过开展“全程输血质量管理”,严格执行操作规程,实施同一患者血型和交叉配血2份血液标本检测结果比对的安全措施可有效降低输血风险。Objective Through retrospective analysis of the inconsistency of the two blood type identification results of blood samples before and after the implementation of the“comprehensive blood transfusion quality management”in our hospital,the reasons were investigated and analyzed,and improvement measures were proposed to ensure the safety of clinical blood use.Methods We performed a comparative analysis of the 2 blood type identification results of blood samples which were tested in the first three years(January 2015 to December 2017)and the later three years(January 2018 to December 2020)in our hospital after implementation of“Comprehensive Blood Transfusion Quality Management”Results From 2015 to 2020,a total of 12,023 cases of blood type identification were performed twice,and a total of 46 blood samples were identified with inconsistent results.The incidence rate was 0.038%,including 34 cases(0.061%)in the first three years and 12 cases(0.019%)in the later three years(P<0.05).The related factors were investigated and analyzed.In the first three years after the implementation of“Comprehensive Blood Transfusion Quality Management”,the main reason was the wrong identification of patients,and the main responsibility was the nurse.In the later three years after the implementation of“Comprehensive Blood Transfusion Quality Management”,the main reason was that patients borrow other people’s information,and the main responsibility was the patient.Conclusion The risk of blood transfusion can be effectively reduced by carrying out“Comprehensive Blood Transfusion Quality Management”,strictly implementing the operating procedures,and comparing the test results of two blood samples of the same patient’s blood type and cross matching.

关 键 词：2次血型鉴定 全程输血质量管理 输血安全 

分 类 号：R457[医药卫生—治疗学]