精益六西格玛在降低儿童血液标本溶血率中的应用  

Application of Lean Six Sigma in Reducing the Hemolysis Rate of Children's Blood Samples

作　　者：陈熳妮[1] 夏萍[1,2] 马钰桦 林美珍 王彩仁[1] 沈玉珍[1] HEN Manni;XIA Ping;MA Yuhua;LIN Meizhen;WANG Cairen;SHEN Yuzhen(The Second Affiliated Hospital of Guangzhou University of Chinese Medicine/Guangdong Provincial Hospital of Chinese Medicine,Guangzhou City,Guangdong Province,China 510120;School of Public Health and Management,Guangzhou University of Chinese Medicine,Guangzhou City,Guangdong Province,China 510000)

机构地区：[1]广州中医药大学第二附属医院/广东省中医院,广东广州510120 [2]广州中医药大学公共卫生与管理学院,广东广州510000

出　　处：《卫生职业教育》2023年第4期143-147,共5页HEALTH VOCATIONAL EDUCATION

基　　金：广东省卫生经济学会2021年科研课题立项(2021-WJZD-18)。

摘　　要：目的探讨精益六西格玛在降低儿童血液标本溶血率和改善血液标本采集流程中的应用效果。方法将2019年4月1日—6月30日363份患儿血液标本作为改善前,2019年7月1日—10月30日528份患儿血液标本作为改善后。改善前采用常规血液标本采集流程,改善后采用精益六西格玛管理。比较改善前后的溶血率、血液标本采集流程时间和主要问题发生次数。结果改善后,患儿血液标本溶血率(2.46%)低于改善前(10.47%),差异有统计学意义(χ^(2)=25.55,P=0.00);患儿血液标本采集流程由改善前的(11.10±1.24)分钟缩短至改善后的(7.02±1.04)分钟,差异有统计学意义(t=51.457,P=0.00);改善后无针接头采血、操作流程不规范、操作护士年资低、采血管顺序不规范、运送时间长等主要问题发生的次数明显低于改善前,差异均具有统计学意义(P<0.01)。结论运用精益六西格玛管理可改善患儿血液标本采集的流程,降低患儿血液标本的溶血率,提升临床护理及标本检验的工作质量。Objective To explore the application effect of Lean Six Sigma in reducing hemolysis rate of children's blood samples and improving blood sample collection process.Methods 363 blood samples of children from April 1 to June 30,2019 were taken as before the improvement,and 528 blood samples from July 1 to October 30,2019 were taken as after the improvement.Before improvement,the routine blood sample collection process was adopted,and after improvement,lean six sigma management was adopted.The hemolysis rate,blood sample collection process time and the number of major problems before and after improvement were compared.Results After improvement,the hemolysis rate of blood samples of children(2.46%)was lower than that before improvement(10.47%),the difference was statistically significant(χ^(2)=25.55,P=0.00);The blood sample collection process was shortened from(11.10±1.24)minutes before improvement to(7.02±1.04)minutes after improvement,with a statistically significant difference(t=51.457,P=0.00);After improvement,the number of major problems such as needle free blood collection,nonstandard operation process,low seniority of operating nurses,nonstandard blood collection sequence,and long delivery time was significantly lower than that before improvement(P<0.01).Conclusion The application of lean six sigma management can improve the process of blood sample collection for children,reduce the hemolysis rate of blood samples for children,and improve the quality of clinical nursing and sample inspection.

关 键 词：精益六西格玛 儿童 血液标本 溶血率 

分 类 号：R197.323.6[医药卫生—卫生事业管理]