血细胞形态学检查室间质量评价结果分析与人员能力提高

The Analysis of External Quality Assessment Results and Improvementof Personnel Capacity for Blood Cell Morphology Examination

目的通过参加国家卫生健康委临床检验中心(National Center for Clinical Laboratories,NCCL)室间质量评价活动评估临床实验室形态学检查的检测能力,协同开展专项培训与人员能力评估,促进实验室质量提高。方法实验室通过NCCL网站查看电子版质评图片,完成图片识别与结果上报,收到回报结果后开展自我评估,对自评不通过项目进行原因分析与人员形态学专项培训。结果2013年至2020年共参加24次血细胞形态学检查室间质量评价活动,考查237幅图片,实验室自评不通过5幅图片,项目总符合率为97.89%。专项培训后,实验室人员血细胞形态学考核成绩明显提高,总成绩中位数由96(90,100)增长到98(96,100),人员合格率由89.3%上升到97.3%。结论鉴于血细胞形态学检查在疾病诊治中的重要作用,提高符合率达到100%是我们工作中的要求,针对不符合的每一个错误结果进行认真分析和人员培训,加强人员能力比对、定期进行能力考核等,保证为临床诊疗提供准确检验依据。

Objective By participating in National Center for Clinical Laboratories(NCCL)External Quality Assessment activities,we evaluated the ability of clinical morphology examination and carried out special training and personnel capacity evaluation to facilitate the improvement of laboratory quality.Methods We checked the quality rating images from the NCCL website,completed the morphology examination and reported the results to the NCCL.We then carried out self-assessment according to the feedbacks from the NCCL and analyzed the potential reasons for the items that failed the self-assessment and conducted morphology examination training for the staff.Results From 2013 to 2020,the laboratory participated in 24 quality assessment activities of blood cell morphology examination from NCCL.Five images failed in the self-assessment and the total compliance rate was 97.89%.After the special training,the blood cell morphology examination results of laboratory staff were significantly improved.The median total score increased from 96(90,100)to 98(96,100),with qualification rate from 89.3%to 97.3%.Conclusion Blood cell morphology examination plays an important role in the diagnosis and treatment of disease,which can be critical to improve the qualification rate of morphology examination to 100%.For each unqualified result,taking special training and periodical ability assessment to enhance personnel ability is an effective way to ensure the accurate examination for the clinical diagnosis and treatment.