新生儿疾病筛查质量管理中存在的问题与对策

Problems exist in neonatal disease screening quality management and its counterm easure

新生儿疾病筛查工作中任何一个环节出现纰漏 ,都将直接影响患者的检出和治疗效果。因此 ,应加强新生儿疾病筛查的质量管理 ,使新生儿疾病筛查工作规范化。山东省对 1 6个市级新生儿疾病筛查中心进行了质量检查评审 ,发现了血样采集、递送、验收、实验分析、可疑阳性的追回以及阳性患儿的诊断治疗与随访工作中存在的不同问题。针对不同筛查中心存在的问题进行了现场纠正与指导 ,并提出了相应的措施和策略 ,加强各环节的质量管理工作 ,包括加强卫生行政部门的组织管理 ,采血人员和实验室技术人员的培训 ,建立严格的验收登记制度及规范化的标准实验室 ,提高可疑阳性患儿的追回率 ,加强阳性患儿的系统管理 ,建立治疗保障机制等 ,使各市级筛查中心在质量管理上得到了不同程度的提高 。

The analysis outcomes and favorable prognosis are affected by every careless mis take in each step of newborn screening. Thus the newborn screening quality manag ement should be strengthened and standardized. The quality systems of 16 newborn scre ening centers were evaluated. Problems were found in blood collection, transport ation, sample acceptance, laboratory analysis, follow-up of suspicious positiv e s, and diagnosis and treatment of patients. On the-spot guidance, instruction a n d resolution way were provided to every center. Intensifying coordination of loc al health departments, training blood collectors and technician s , recording acceptable and unacceptable samples, standardizing laboratory, incre asing follow-up rate of suspicions positives, strengthening patient administra t ion and ensuring treatment of every patient were included in those ways. As a re s ult, the quality management was enhanced and a developed assurance system was es tablished in Shandong.