2017—2019年全国临床检验中心室间质量评价结果分析

Analysis of External Quality Assessment Results of National Clinical Laboratory from 2017 to 2019

目的对安康市中心医院2017—2019年参加全国临床检验中心室间质量评价结果进行总结分析,探讨临床实验室检测的准确性和可比性,持续提高临床实验室检测能力和质量管理水平。方法依据全国临床检验中心室间质量评价活动安排,对各个参评项目使用常规检测方法在规定时间内完成检测工作,并通过网络形式报告检测结果,及时对回报结果进行总结分析。结果该院检验科参加全国室间质量评价总成绩合格,各个专业室间质量评价成绩为满意,年度总成绩性能评价均为成功。临床化学、免疫学、微生物学专业中个别项目均存在不合格现象。显微镜形态学检查正确率低,2017年血细胞、尿沉渣和寄生虫形态学检查室间质评符合率分别为73%、93%和67%,2018—2019年,形态学结果较为理想。结论通过室间质量评价结果反馈,在检测项目校准问题、试剂批间差异、设备功能障碍以及结果上报方面存在不足。显微镜形态学检查,须结合整个视野有形成分形态学特点综合分析,对细胞典型特征的质和量进行全面评估,减少误判。微生物鉴定室间质量评价标本的检测,可积累临床少见的疑难细菌鉴定经验,及时发现和总结不足之处。同时室间质量评价作为一种教育工具,强化基础知识、重视基本技能培训,制定行之有效的改进措施,建立完善的适合自身的质量管理体系,将质量控制工作贯穿实验全过程。

Objective To discuss the accuracy and comparability of the results from the clinical laboratory and improve the detective level and quality management continuously by summarizing and analyzing the external quality assessment results of the National Clinical Laboratory in the years from 2017 to 2019.Methods According to arrangement for the external quality assessment activities of the National Clinical Laboratory,all the projects were required to be evaluated by the routine test method in the limited time.The test work was completed and the test results were reported via network,and the results were summarized and analyzed in time.Results The performance of the laboratory of AnKang Central Hospital was satisfactory in the National External Quality Assessment.The results of each specialized department all met the requirements.Individual sub-items of the Clinical Chemistry,Immunology,Microbiology examinations still had some unqualified projects.The accuracy of microscopic morphlogy exmination was low.The coincidence rate of blood cell,urinary sediment and parasite morphological external quality assessment respectively was 73%to 93%and 67%in 2017.However,the results of morphological examination were ideal in 2018 and 2019.Conclusion According to the feedback of the results of the external quality assessment,there were some deficiencies in the calibration of the test system,the differences among reagent batches,the performance obstacles of equipment and the report of the results.In order to reduce miscalculation,it is necessary to evaluate the quality and quantity of the typical cell characteristics in combination with the morphological characteristics of the whole visual field.The quality assessment for samples through microbiological identification can accumulate the rare clinical experience of difficult bacteria identification,and find and summarize the deficiencies in time.At the same time,as a kind of educational tool,the quality evaluation in the room strengthens the basic knowledge,attaches importance to the basic skill training,formulates the effective improvement measures,establishes the perfect quality management system suitable for itself,and makes the quality control work throughout the whole experiment process.