临床血液标本检验不合格的原因及应对

Causes and Countermeasures of Disqualification in Clinical Blood Specimen Examination

目的分析血液标本临床检验不合格的原因,提出相应对策,以提高检验效率和送检标本质量。方法收集2018年7月至10月送至山东省菏泽市定陶区人民医院检验科的血液标本资料,按《全国临床检验操作规程》中规定的标本验收要求进行验收登记,对分析前发现血液标本不合格的原因进行统计分析,并提出可操作性对策。结果送检血液标本共12827份,不合格血液标本481份,标本不合格率为3.75%。造成血液标本不合格有多方面原因,主要有:标本溶血;凝血或抗凝不充分;采血量不准确,不能满足检测需要;采血容器或材料不合格;标本信息错误,与患者姓名不符;对患者交待不清,受检者准备不足;标本送检延误超时等。结论为进一步提高样本质量,应加强对从业人员的职业道德教育,定期进行专业技能培训;规范血液标本采集、送检、储存等操作流程,完善相关制度规定,包括标本送检交接制度、不合格标本登记制度等;认真操作,及时送检;加强检验科室与临床科室沟通协作。

Objective To analyze the causes of disqualification in clinical examination of blood samples,and to put forward corresponding countermeasures in order to improve the efficiency of examination and the quality of samples sent for examination.Methods Data of blood samples sent to the laboratory of our hospital from July 2018 to October 2018 were collected and registered according to the requirements of acceptance and acceptance of blood samples stipulated in the National Practice for Clinical Laboratory.The reasons for the unqualified blood samples were analyzed and the corresponding countermeasures were put forward.Results A total of 12827 blood samples were sent for examination,481 were unqualified blood samples,and the unqualified rate was 3.75%.There were many reasons for the disqualification of blood specimen,such as:hemolysis of specimen;insufficient coagulation or anticoagulation;inaccurate quantity of blood collection which can not meet the need of detection;unqualified blood collection container or material;incorrect specimen information and inconsistent with the patient's name;insufficient preparation of the examinee due to lack of clarity;delay and overtime of specimen delivery,etc.Conclusion In order to further improve the quality of samples,professional ethics education should be strengthened and professional skills training should be carried out regularly.To standardize the operation flow of blood sample collection,inspection and storage,and improve the relevant regulations,including the delivery and handover system for blood samples and the registration system for unqualified samples;Operate carefully and submit for inspection in time;Strengthen the communication and cooperation between the testing department and the clinical department.