临床病原学送检现况调查及管理对策

Prevalence survey and management countermeasures of clinical etiology submission

目的探讨提高临床病原学检查质量的管理方法,促进抗菌药物合理应用。方法对2011年4-12月抗菌药物治疗应用病原学送检率与送检时机进行回顾性调查,并通过到临床各科室现场查看微生物标本采集和运送的全过程,查找与分析病原学送检过程中存在的问题,提出管理对策。结果全院抗菌药物治疗应用病原学送检率为49.25%,送检率由高到低依次是儿科、ICU、内科、妇产科、外科、五官科,分别为97.00%、80.00%、66.56%、38.33%、28.87%、6.67%;病原学送检时机不合理占27.26%;采样操作合格率、基本合格率、不合格率分别占34.78%、58.69%、6.52%;标本运送主要由工人完成,以病房护工为主,占91.30%;临床医护人员对微生物标本采集和运送存在不同程度的认知缺陷,对病原学检查结果满意度为68.18%。结论病原学检查质量与临床需求尚有一定差距,急需规范微生物标本采集、运送、接收、实验、报告操作流程,建立有效监督机制。

OBJECTIVE To explore the management measures to improve the clinical etiological examination quality and promote the reasonable use of antibiotics.METHODS Retrospective survey of the clinical etiological submission rate and timing was conducted from Apr to Dec in 2011,the problems existing during the etiology submission process were found out and analyzed through the on-site check of the specimens sampling and the delivery process,the countermeasures were proposed.RESULTS The etiological submission rate was 49.25% in hospital,the submission rates,ranking in a descending order,were as follows： 97.00% of the pediatrics department,80.00% of ICU,66.56% of internal medicine department,38.33% of gynecology and obstetrics,and 28.87% of surgery department,and 6.67% of otorhinolaryngology department;the irrational timing of the etiology submission accounted for 27.26%;the qualified rate of the sampling was 34.78%,58.69% basically qualified,and 6.52% unqualified;the delivery of the specimens was completed by the workers among which the ward nursing staff accounted for 91.30%;the medical staff varied in defect of cognition toward the sampling and delivery of the microorganism specimens,and the satisfaction of the etiological examination results was 68.18%.CONCLUSION The etiology examination quality still lags behind the clinical demand,the operation procedures,including microorganism specimen collection,transportation,reception,examination and report should be standardized,and the effective supervision mechanism should be established.