血液成分输注临床路径应用效果分析

Effectiveness Analysis of Clinical Pathway of Blood Component Infusion

目的分析血液成分输注临床路径应用效果。方法将血液科2019年1月-12月511例住院输血患者分为路径组和对照组,进行应用效果比较分析;并对医护人员和路径管理人员满意度进行问卷调查。结果路径组在输血治疗全过程用时、等候输血医嘱执行时长、医嘱执行到取血时长、例均输血费用方面与对照组相比P<0.05,有统计学差异;路径组平均住院日与对照组相比P>0.05,无统计学差异。路径组输血记录规范合格率、用血合理性评估合格率与对照组相比P<0.05,有统计学差异;输血申请单填写合格率、输血知情同意书签订合格率、输血感染筛查检查率与对照组相比P>0.05,无统计学差异。医护人员和路径管理人员对血液成分输注临床路径内容完整性、流程合理性、诊疗规范性、实用性以及与病种临床路径兼容性满意度较高;认为对规范医疗行为、保障医疗安全、改善医疗质量有积极作用,对医护原有工作模式、工作量影响有限,对缩短住院日无贡献。结论《血液成分输注临床路径专家共识(2018)》科学、合理,实用性强,易推广。应用本路径可以规范输血诊疗,优化流程,节约诊疗时间与输血费用,提高输血质量,保障患者输血安全。

Objective To analyze the effect of clinical pathway of blood component infusion.Methods 511 blood transfusion inpatients in Hematology Department from January to December 2019 were divided into two groups:clinical pathway group and control group,for effectiveness analysis,and questionnaire survey was used to investigate the satisfaction of medical staff and path management staff.Results Compared with the control group,there were statistically significant differences in duration of transfusion treatment,duration of waiting for transfusion order,duration of execution of doctor's order until blood collection,and cost of blood transfusion in all cases in the pathway group(P<0.05).The average length of stay in the pathway group was no statistical difference compared with the control group(P>0.05).Compared with the control group,the qualified rate of blood transfusion record standard and blood use rationality assessment in the pathway group had statistical difference(P<0.05).Compared with the control group,there were no statistically significant differences in the qualified rate of filling in the application form of blood transfusion,the qualified rate of signing the informed consent form of blood transfusion,and the screening rate of blood transfusion infection(P>0.05).Medical staff and pathway management staff were highly satisfied with the completeness of the clinical pathway content,rationality of the process,standardization of diagnosis and treatment,practicability and compatibility with the clinical pathway of blood component infusion.It was believed that it played a positive role in regulating medical behavior,ensuring medical safety and improving medical quality,had limited influence on the original working mode and workload of medical care,and had no contribution to shortening hospital stay.Conclusion"The Expert Consensus on Clinical Pathway of Blood Component Infusion(2018)"is scientific,reasonable,practical and easy to popularize.The application of this pathway can standardize the diagnosis and treatment of blood transfusion,optimize the process,save the diagnosis and treatment time and the cost of blood transfusion,improve the quality of blood transfusion,and ensure the safety of blood transfusion for patients.