甘肃省三级以上医疗机构临床合理用血现状调查

Investigation into the Current State of Rational Clinical Blood Use in Grade-A Tertiary Hospital of Gansu

目的:了解甘肃省三级医院临床合理用血的现状。方法:从甘肃省临床用血质控中心专家组中抽取17名专家,分成5个小组。于2015年5月9日至27日,依据《甘肃省临床科学合理用血考核评价标准(试行)》,从组织管理、血液管理、输血记录、临床用血和自体输血5个方面,对本省13个地州市35家三级以上医疗机构的临床用血情况进行督导考核,并对考核结果进行汇总分析。结果:12家医院独立设置输血科(34.29%),未真正意义上成立输血科的23家(65.71%);33家医院(94.3%)成立了输血管理委员会,有1家医院输血管理委员会未开展工作;有6家医院输血管理委员会对临床用血没有评价和公示制度;普遍存在中级以下医师填写输血申请单的情况;33家医院(94.30%)存在不合理用血现象,特别是血浆的不合理输注尤为突出;只有2家医院自体输血率达到要求。结论:通过这次的全省医疗机构临床用血督导考核,发现了存在的问题,了解了甘肃临床用血的管理现状,为下一步持续改进梳理应对方案。

Objective: To investigate current state of rational clinical blood use in grade-A tertiary hospitals of Gansu province. Methods: Seventeen experts were selected from the expert group of provincial clinical blood quality control center, and divided into five groups, they supervised and examined the conditions of clinical blood in 35 grade-A tertiary medical institutions from 13 cities from five aspects: management of organization, blood management, the records of blood transfusion, clinical blood use and autotransfusion from May 9, 2015 to May 27,2015 according to the standard of clinical scientific and rational us of blood assessment in Gansu Province(trail),collected and analyzed the results. Results: There were blood transfusion department set up independently in 12 hospitals(34.29%), and no department established in the true sense in 23 hospitals(65.71%), blood transfusion administration committee established in 33 hospitals(94.3%), a blood transfusion administration committee didn′ t work, and there was no assessment and display system for clinical blood use in six hospital blood transfusion administration committee, the conditions of physician lower than middle rank writing blood transfusion application form existed generally, the phenomenon of irrational blood use existed in 33 hospitals(94.3%), especially the irrational infusion of plasma was prominent, autotransfusion rate in two hospitals met the requirements. Conclusion:The existing problems are found and management state of clinical blood use in Gansu are surveyed by the supervision and examination of clinical blood use in medical institutions in the whole province, therefore to sort out the corresponding plan for continuous improvement next.