中国31个省市自治区部分县乡医院检验人员技术能力培训的实践

Training evaluation of clinical laboratory excellence for technologists from some county and township hospitals in 31 provinces of China

目的 通过对全国各省市自治区的县乡级医院检验技术人员的规范化培训,提高中国县乡医院的临床检验水平.方法 中华医学会检验分会于2010至2013年启动了全国性的“城乡对口支援临床检验技术标准的制订及培训项目”.项目培训前对全国31个省（区、市）445所县乡级医院检验科进行了抽样问卷调研,项目完成6个月后,对其中9个省份的250家参与培训的县乡医院进行抽样调查.结果 在2010至2013年间,项目全面规范化培训了全国31个省市自治区3 570家医院的基层县级医院和乡镇卫生院的检验科主任及技术骨干.培训后评估测验的平均及格率由培训前的16.2％上升至83.7％.29.6％的医院新开展了临床生化项目,开展临床血液学检验、临床免疫学检验和临床微生物检验新项目的医院数量分别占24.4％、21.2％和16.4％.室内质量控制和室间质量评价项目也显著增加,其中,增加临床生化检验质量控制项目的医院最多,分别达12.8％和10.0％;开展临床微生物检验质量控制项目的医院也达到4.4％和2.8％.与此同时,生物安全管理水平也有所提高,开展生物安全风险评估的医院从41.2％增加到了76.4％.结论 通过本项目,县乡级医院临床检验能力得到有效提升,室内质量控制和室间质量评价体系不断健全.

Objective To improve clinical testing excellence through a large scale training project targeting laboratory operators at China＇s county and township hospitals.Methods The Chinese Society of Laboratory Medicine launched the ＂Clinical Laboratory Standards and Training Support Project＂ from 2010 to 2013.The project innovatively created a model of partnership between government,professional association,individual hospitals and other social forces.A survey before training was conducted in 445 county-hospital laboratories in 31 provinces.Six months after implementation,a sampling survey was conducted among 250 participating county hospitals in 9 provinces to assess the project.Results From 2010 to 2013,the project had covered 31 provinces of China,and trained technologists from 3 570 hospitals.After training,the average pass rate of assessment examination increased to 83.7% compared with 16.2% before the training.29.6% hospitals added new biochemistry parameters,and the number of hospital with new hematology,immunology,and microbiology parameters accounted for 24.4%,21.2% and 16.4%,respectively.The internal quality control and external quality assessment items also increased significantly.Biochemistry increased most,reaching 12.8% and 10.0%,and microbiology also reached 4.4% and 2.8% respectively.Bio-safety management capacities were also enhanced.The number of hospital implementing bio-safety risk assessment increased from 41.2% to 76.4%.Conclusions This project helpfully fills an important technical gap of clinical testing in China＇s rural healthcare infrastructure.Through training,clinical laboratory operations has been standardized,and systems of internal quality control and external quality assessment are increasingly improved.