临床渗及信息反馈路径对检验前质量控制的作用

Research on the function of clinical permeability and information feedback path in quality control before test

目的通过对我院检验科ISO 15189国家实验室认可前后检验前质量控制情况进行分析,探讨检验科建立的临床渗及信息反馈路径在检验前质量控制中的作用,以减少分析前误差的发生,提高检验质量。方法采用调查研究的方法,统计并分析路径建立前（2009年）和路径建立后（2010~2014年）各年度不规范申请单发生率、标本丢失率、不合格标本发生率,并对其在不同科室的分布情况及原因进行分析。结果与临床渗及信息反馈路径建立前（2009年）相比,2010年建立路径后不规范申请单发生率、标本丢失率、不合格标本发生率均明显下降（P〈0.05）;2010~2014年随着路径的规范和完善,差错的发生率呈逐年下降趋势。结论建立检验医师查房、会诊制,临床护师标本采集的培训、考核,定期开展由院领导、临床医护人员、职能科室主任参加的管理评审等措施的临床渗及信息反馈路径可提高临床医护人员的质量意识,规范标本采集的技术操作,大大提高了标本质量。

Objective To explore the function of clinical permeability and information feedback path in clinical laboratory about the quality control before test by analyzing the control condition before test before and after the national laboratory accreditation through the ISO 15189, to reduce the errors and improve the quality of inspection. Methods The investigation and study methods were used to analyze the relevant materials in ISO 15189 before（2009） and after（2010-2014） the national laboratory accreditation（such as unqualified application form, specimen loss, unqualified specimen）, the causes about the distribution in different departments were analyzed. Results Compared with 2009, after clinical permeability and information feedback path was established（2010-2014）, the phenomena such as unqualified application form, specimen loss, unqualified specimen were markedly reduced（P0.05）, from 2010 to 2014, with the path was more and more normative and perfect, the incidence of errors declined year by year. Conclusions Clinical permeability and information feedback path can improve the quality of clinical medical personnel consciousness, standard specimen collection technical operation, greatly improve the quality of the specimen by establishing inspection physician rounds, consultation system, training and evaluating collection of clinical specimen, clinical medical personnel and directors of the department functions participating in the management review and other measures.