某大型综合医院建院第一年检验科不合格标本的调查分析

Investigation and analysis on the rejected specimens of the examination section of a large general hospital during the first year

目的对某院建院一年内检验科出现的不合格标本进行分类统计和原因分析,探讨降低标本不合格率、提高分析前标本质量的方法。方法收集2016年1月1日至2016年12月31日检验科不合格标本的各项数据,包括拒收原因、数量、送检科室、标本类型等,经过数据整理后采用SPSS 17.0统计软件分析。结果血液类型标本占不合格标本的82.79%;标本有凝块、溶血、标本量少、标本污染、标本类型错误是标本不合格的主要原因;急诊、ICU、呼吸内科、心血管内科和神经内科送检的标本不合格率较高;3月、8月、11月的送检标本不合格率较高。结论重视分析前质量控制,加强检验科与临床医护、患者、护工三方的沟通与合作非常重要;针对不同情况采取相应整改措施,切实降低送检标本的不合格率。

Objective Rejected specimens in the laboratory within one year were classified statistically and causes were analyzed, in order to explore the methods of decreasing the number of rejected specimens and improving the pre-analytical quali- ty. Methods The data of the rejected specimens of the laboratory from January 1,2016 to December 31, 2016 were collected, including the reasons for rejection, quantities, inspection departments, and types, etc. Then SPSS 17.0 statistical software was used for analysis after data process. Results The percentage of rejected blood specimens was 82.79%. The main reasons of re- jected specimens were specimen clotted, hemolysis, insufficient specimen quantity, contamination and improper specimen type. The rejection rates of the emergency, ICU, respiratory medicine, cardiovascular medicine and neurological medicine were com- paratively high. The rejection rates of comparatively high in March, August, and November. Conclusion Quality control before analysis should be valued. It is important to strengthen the communication and cooperation between the laboratory and the clinical departments, the patients and the nursing workers. The corresponding corrective measures should be taken to reduce the percent- age of rejected specimens.