临床用血危急值初探及管理体会

Understanding on the establishment and management of critical value in clinical blood transfusion

临床用血危急值的设立及管理主要是为了保证临床用血质量和输血安全,通过查阅国内外输血科指南、相关文献并结合医院自身特点我院输血管理委员会建立了14项临床用血危急值项目并于2013年1月纳入临床危急值报告管理程序。本院输血科2013-2015年共记录临床用血危急值554例,实际临床用血248例,占44.8%;通过对临床用血危急值管理实现了急诊用血、正反定型不符和交叉配血不合抢救用血、大量输血等用血100%安全及时;输血不良反应上报处理100%;非计划用血下降50%;输血相关标准差错减少87.5%,有效提高了及时安全用血比率,减少了引发输血事故和医疗纠纷的潜在隐患,对临床用血安全方面起到了很好的警示和管理作用。

The establishment of critical value in clinical blood transfusion primarily aims to ensure the quality and safety of blood transfusion. In our hospital,the total of cases identified with critical values in clinical blood transfusion numbered 554 between January 2013 and December 2015,among which,the actual clinical use numbered 276 cases,accounting for 49. 8%. Through the management of critical value of clinical blood transfusion,inconsistent emergency blood use was reduced,improved emergent blood transfusion during positive and negative crossmatch in a timely manner. Adverse transfusion reaction report processing achieved 100%. Unplanned blood transfusion fell by 50%. Serious transfusion related errors decreased by 87. 5%. It effectively improved the critical value of timely safety ratio and reduced the potential risks of blood transfusion accidents and medical disputes,and also gave an appropriate warning in clinical blood transfusion. It is recommended that the hospital transfusion management committee should establish a critical value in clinical blood transfusion,evaluate and track the effect of critical value in clinical blood transfusion on a regular basis. In the meantime,it is recommended to evaluate the effect of blood transfusion and the safety of blood transfusion in a timely fashion.