建立质量管理体系 实现输血全过程管理

Establish the Quality Management System and Implement the Comprehensive Management of Blood Transfusion Process

目的通过建立完善的输血质量管理体系，实现输血全过程的质量管理。方法参照国内外质量管理体系标准，结合本实验室实践，构建输血质量管理体系，并采取有效措施保障该体系的有效运行和持续性改进。结果2011～2013年悬浮红细胞和血浆使用量以及年用血量同期相比，平均下降率〉12％；2013年第三季度与第一季度相比，输血前指征综合评估合理率上升9．5％（x2=1．74，P=0．04），输血后效果评价执行率上升12．4％（x2=1．92，P=0．03），输血后效果评价有效率上升10．4％（x2=1．90，P=0．03），均呈上升趋势。输血全过程中，无用血不良质量安全事件反生，2011～2013年各类输血不良反应总发生率低于0．5％，过程中的每个关键节点均清晰可控。结论通过建立操作性强、适合自身实际情况的质量管理体系，实现了对输血全过程的质量管理，对提升科学合理用血的质量管理有重要作用。

Objective To implement the comprehensive process management by establishing and improving the quality management system of blood transfusion. Methods Adopt effective measures to guarantee the normal operation and continuous improvement of the system, according to the quality management system standards home and abroad, basing on the practice of our laboratory. Results Compared with the same period of time, the usage of suspension red cell, plasma and whole blood in year 2011 to 2013 decreased more than 12% on average. Compared with the first season of 2013, the third season showed a reasonable improvement in pre-blood-transfusion composite assignment （9.5%） and after-blood- transfusion effectiveness assignment （10.4%）. During the whole process of blood transfusion, not a case of unqualified blood supplement occurred and all kinds of untoward effects happened at a rate of less than 5% in the year 2011 to 2013. All nodes in the process is under control. Conclusion The quality management of blood transfusion process can be implemented through establishing the operable quality management system which is suitable for one＇ s own practical situation, and is of great importance to the quality management of the scientific and rational use of blood.