血细胞分离机单采过程抗凝剂和生理盐水连接错误原因分析及预防

Cause analysis and prevention of wrong connection between anticoagulant and normal saline solution during apheresis platelet donation

目的探讨血细胞分离机单采过程抗凝剂和生理盐水错误连接的原因及有效预防措施,保障单采献血者的安全。方法第1阶段2008年12月至2016年9月采用人工校核方法;第2阶段2016年10月至2020年10月采用人工和信息系统辅助双校核方法。行Fisher’s Exact Test双侧检验,对比校核方法改进前后溶液连接错误发生率。结果第1阶段单采过程溶液连接错误发生率为1.02/万;Amicus与Trima+Mcs;+血细胞分离机溶液连接差错率之间,P<0.05;第1、2阶段总差错率比较,P>0.05;第2阶段推行人工和信息系统双校核方法后,未再发生抗凝剂和生理盐水连接错误的情况。结论采用人工和信息系统辅助双校核方法,可有效预防抗凝剂和生理盐水连接错误的发生。

Objective To explore the reasons for wrong connection between anticoagulant and normal saline solution during apheresis platelet donation, as well as the preventive measures, so as to ensure the safety of apheresis platelet donors. Methods Manual checking in the first phase(December 2008 to September 2016) was compared with double checking(manual checking plus information system) in the second phase(October 2016 to October 2020) via bilateral testing using Fisher’s Exact Test to study pre-post-improvement differences. Results The incidence of solution connection errors during apheresis platelet donation in the first phase was 1.02/10 000, and the error incidence between Amicus and Trima + Mcs;blood cell separator was statistically significant(P<0.05). The total incidence of errors between the first and second phases was not statistically significant(P>0.05). After the performance of double checking in the second phase, no wrong connection of anticoagulant and saline solution occurred. Conclusion The double checking method assisted by manual and information system can effectively prevent the wrong connection between anticoagulant and normal saline solution.