质量控制小组对提高结核科患者痰标本采集质量的作用

Effectiveness of quality control team on improving quality of sputum specimens collected from patients with tuberculosis

目的探讨质量控制小组对提高结核科患者痰标本采集质量的作用。方法2014年11月广州市胸科医院内科成立质量控制小组。质量控制小组采取建立患者痰标本采集流程和相关指引，加强对患者的健康教育，加强医护人员相关知识培训，普及护士对痰标本采集的规范操作和宣传教育要点，责任到人、分工细化、明确职责等措施。2014年8月1日至2014年10月31日质量控制小组成立前收治320例疑似肺结核患者，医嘱留痰2088份；2014年11月1日至2015年2月28日质量控制小组成立后收治的386例疑似肺结核患者，医嘱留痰2417份。比较质量控制小组成立前后痰标本采集率和合格率。应用SPSS19．0统计软件进行数据分析，计数资料采用z。检验，以P〈O．05为差异有统计学意义。结果质量控制小组成立前痰标本采集率为84．6％（1767／2088），痰标本合格率为86．3％（1525／1767）；质量控制小组成立后痰标本采集率为95．0％（2295／2417），痰标本合格率为96．0％（2203／2295），两者痰标本采集率和痰标本合格率差异均有统计学意义（x2值＝6．999和5．361，P值=0．008和0．021）。结论成立质量控制小组，对收集患者痰标本的工作过程进行严格的质量控制，能有效提高结核科患者痰标本的采集质量。

Objective To explore the effect of the quality control team on improving the sputum specimens＇ quality when collected them from the patients with tuberculosis （TB）. Methods A quality control team was established in our department in November 2014 and a series of measures were carried out by the team, including： the procedures and instructions for sputum sample collection were developed, education to the patients and training to the related staff were strengthened, the standard operation of sputum specimen collection was taught to the related nurses, the staff responsibilities were determined and the responsible persons were assigned. Following the doctors＇ advices, 2088 sputum samples should be collected from 320 pulmonary TB suspects from August 2014 to October 2014 before the quality control team was set up, while 2417 sputum specimens should be collected from 386 pulmonary TB suspects from November 2014 to February 2015 after the quality control team was set up. The rates that the sputum specimens were successfully collected and the qualified sputum specimens were collected before and after the quality control team was set up were compared. The SPSS 19.0 statistical software was used for data analysis. Chi-square test was used for comparing the proportions and P〈0.05 was considered to he statistically significant difference. Results Before the quality control team was established, the collection rate of the patients＇ sputum specimens was 84.6% （1767/2088） and the proportion of the qualified sputum specimens among the collected sputum was 86.3% （1525/1767） ; after the quality control team started their work, the collection rate of the patients＇ sputum specimens was 95.0% （2295/2417） and the proportion of the qualified sputum specimens was 96.0% （2203/2295）. The differences of the sputum specimen collection rate and the qualified sputum specimen rate before and after the quality control team was established had statistical significance （X2= 6. 999 and 5. 361, P=0. 008 and 0. 021）. Conclusion To set up a quality control team and enforce strict quality control during the process of sputum specimen collection can effectively improve quality of the sputum specimens which collected from the patients with TB.