河北省三级综合性医院临床用血管理现状调研

Investigation on current situation of clinical blood management in tertiary general hospitals of Hebei province

目的调查三级医院临床用血管理现状,并提出做好临床用血的合理化建议。方法对河北省42家三级医院进行调查。按照评分标准,通过听取汇报、查看文件、现场检查、问卷调查、查阅病历、考核等方式,从临床用血管理、输血科(血库)建设、输血病历管理三个方面进行了全面的检查评估。结果根据总分将医院分为4个等级,一级~四级的医院数量分别为9、14、10和9家,总评分(200分)分别为(192.6±2.08)分、(183.5±2.09)分、(175.6±3.22)分和(161.7±5.36)分,临床用血管理(75.3分)分别为(73.3±1.09)分、(69.7±2.66)分、(66.2±3.58)分和(59.0±7.29)分,输血科管理分(45.7分)分别为(44.6±0.91)分、(42.8±1.74)分、(42.1±1.89)分和(39.1±4.62)分,病历管理分(79.0分)分别为(74.7±1.95)分、(71.1±2.60)分、(67.3±2.78)分和(63.6±7.57)分。结论河北省三级医院在用血管理体系建设、管理工作落实、输血科硬软件建设等方面存在许多不足。做好临床用血管理的顶层设计,加强基础设施和技术建设,完善培训考核制度,强化责任意识,狠抓监督管理是做好临床用血管理的有效办法。

Objective To investigate current situation of clinical blood management in tertiary general hospitals,and to raise rationalization proposal for clinical blood management.Methods Forty-two tertiary general hospitals of Hebei province were investigated on clinical blood management.Clinical blood management,construction of blood transfusion department,blood transfusion medical records were inspected and evaluated via the report hearing,data check,on-site inspection,questionnaires and testing.Results The hospitals were divided into four grades based on total points scored,the number of such hospitals thorough from Grade 1 to Grade 4 were 9,14,10 and 9 respectively,and total points scored were(192.6±2.08)points,(183.5±2.09)points,(175.6±3.22)points and(161.7±5.36)points,the scores of clinical blood management of hospital were(73.3±1.09)points,(69.7±2.66)points,(66.2±3.58)points and(59.0±7.29)points respectively,the scores(45.7 points)of blood transfusion department were(44.6±0.91)points,(42.8±1.74)points,(42.1±1.89)points and(39.1±4.62)points respectively,the scores(79.0 point)of blood transfusion medical records were(74.7±1.95)points,(71.1±2.60)points,(67.3±2.78)points and(63.6±7.57)points respectively.Conclusion Substantial insufficiencies for construction and implementation of clinical blood management service,software and hardware construction of blood transfusion department were found with tertiary general hospitals in Hebei.It is an effective measure to properly implement top level design of clinical blood management,strengthen infrastructure and technology construction,improve training and assessment system,emphasize the sense of responsibility,and strictly tighten on supervision and management.