血气分析自动审核规则的评估与优化

Evaluation and optimization of autoverification rules for blood gas analysis

目的评估和优化血气分析的审核规则,提高自动审核通过率。方法回顾分析8453份血气标本的自动审核通过率。参考CLSI AUTO-15、CLSI EP33,评估和优化血气项目的限值和差值范围。调整规则并通过验证后,重新计算自动审核通过率。结果血气分析的自动审核原有规则15个项目共64条,自动审核通过率是46.4%。不通过原因差值占22.5%,限值占22.3%。调整差值规则6条,如氧分压差值百分率从“<-130%或>130%”调整为“<-180.6%或>234.3%”。调整限值规则8条,如警戒总氧含量从“<2.5 mmol/L或>20.4 mmol/L”调整为“<4.1 mmol/L或>23.4 mmol/L”。928例验证人工审核和自动审核的符合率100%。规则调整后自动审核通过率是66.2%。结论合理地调整限值和差值范围可提高自动审核的通过率。

Objective To evaluate and optimize the autoverification rules for blood gas analysis so as to improve the pass rate of autoverification.Methods The passing rates of 8453 blood gas samples in autoverification(AV)were retrospectively analyzed.The limits and of blood gas items were evaluated and optimized by referring to CLSI AUTO-15 and CLSI EP33.After adjusting the rules,the passing rates of autoverification were recalculated.Results There were 64 rules in 15 items in the original autoverification rules for blood gas analysis.The passing rate of autoverification was only 46.4%.The delta check accounted for 22.5% and the limit value accounted for 22.3% in the failed reasons.Six delta check rules were adjusted,for example,the percentage of delta check for oxygen partial pressure was changed from"<-130 or>130%"to"<-180.6% or>234.3%".Eight limit rules were adjusted,for example,the alert of total oxygen concentration was changed from"<2.5 mmol/L or>20.4 mmol/L"to"<4.1 mmol/L or>23.4 mmol/L".The agreement rate of manual audit with autoverification was 100% in 928 cases.The passing rate of autoverification was 66.2% after the rule adjustment.Conclusion Reasonably adjusting the limits value and delta check range may improve the passing rate of autoverification.