江西省三级医疗机构输血科建设与持续改进调查分析

Investigation and analysis on the construction and continuous improvement of blood transfusion department in tertiary hospitals in Jiangxi Province

目的通过江西省三级医疗机构输血科建设与持续改进情况的调查分析,为医疗机构和卫生行政部门对输血科建设与临床输血管理决策提供依据。方法 2013年5月采用电子表格形式对江西省45家三级医疗机构输血科进行问卷调查,并根据问卷调查情况制定下发了《江西省医疗机构输血科建设与临床用血管理评估标准》(下称"标准"),以用于输血科建设持续改进;2014年10月依据"标准"对其中23家医疗机构输血科进行现场调查,调查内容包括输血科基本设施与制度建设、技术开展、仪器设备、人员结构等;对23家医疗机构2次调查数据进行统计分析。结果 1)输血科在独立设置、用房面积、专职技术人员与必备仪器设备配置、输血培训、输血技术开展等方面建设较2013年有较大持续改进:1三级医疗机构独立设置输血科明显增加,占87.0%(P<0.05),平均用房面积由132m2提高至152 m2;2临床输血培训比例增加17.4%(P<0.05);3患者ABO、Rh D血型确认试验普及率达100%,其他技术开展亦有不同程度提高;4必备仪器设备配置中普通冰箱、普通离心机、37℃水浴箱、专用电话配置率达100%(P<0.05);5专职技术人员所占比上升11.5%,临床医师所占比提高3.2%。2)高级职称技术人员和高学历人员所占比无明显变化,除ABO血型外其他输血技术开展有待提高,少数必备仪器设备配置率未达100%,信息化管理水平滞后。结论江西省三级医疗机构输血科在硬件设备设施、管理组织与制度、人员配置与培训、技术开展等方面建设均有不同程度持续改进,但仍存在少数必备仪器设备配置不全、信息化管理落后,技术开展较为局限,高学历高称职人才不足等问题,有待于进一步加强完善。

Objective To conduct a survey on the construction and continuous improvement of blood transfusion depart- ment in tertiary hospitals in Jiangxi Province, which can provide guidance for the medical institutions and the health adminis- trative departments in promoting the construction of Blood Transfusion Department and clinical transfusion management. Methods In May 2013, survey data from 45 medical institutions were collected using electronic questionnaires. Jiangxi Province Planning Commission established ＂Blood transfusion and clinical use of blood management assessment criteria of medical institutions＂ （hereinafter referred to as ＂criteria＂） according to the investigation for continuous improvement of blood transfusion department. 23 of the 45 medical institutions were investigated by the field investigation in November 2014 according to the criteria. The investigation contained： basic facilities and system construction, blood transfusion technology development, equipment, personnel structure, etc. A statistical analysis was conducted on the data from twenty three partici- paring medical institutions. Results Huge improvement was observed in the construction of independence set, room area, full-time technical personnel and the necessary equipment configuration, blood transfusion training, blood transfusion tech- nology development in 2013. Setting up independent blood transfusion department of the tertiary hospitals increased signifi- cantly, accounting for 87% （P 〈0. 05）. The average housing size increased to 152 square meters from 132. Clinical blood transfusion training was carried out with a 17. 4% increase （P 〈0. 05）. The utilization rate of patient＇s ABe, RhD blood group confirmation test was 100%. Improvement was also seen in other related technology with different levels. The utiliza- tion ratio of the ordinary refrigerator, ordinary centrifuge, thirty seven centigrade water bath box, dedicated telephone ap-preached 100% in 2014. The proportion of full-time staff of blood transfusion department has increased by 11.5%. The proportion of clinicians increased by 3.2%. No obvious change was seen in the proportion of senior technical personnel and high-ly educated personnel. In contrast, other blood transfusion technology demonstrated room for improvement. The allocation rate of minor necessary instrument equipment was less than 100%. The level of informatization management lagged behind. Conclusion The construction of hardware facilities, management organization and System, personnel allocation and train- ing, technical development and other aspects show varying degrees of improvement in blood transfusion department in tertiary hospitals in Jiangxi Province, however, some issues remain to be improved, such as incomplete configuration of necessary e- quipment, delayed informatization management, limited technology development and shortage of senior technical personnel and highly educated personnel.