降低外科病房血液檢體退件率

Improve Rejection of Specimens in the Surgical Ward

葉玄麗(Hsuan-Li Yeh) ； 許莉宛(Li-Wan Hsu) ； 李昀蓁(Chun-Chen Li)

《高雄護理雜誌》 36卷2期 (2019/08) Pp. 17-27

https://doi.org/10.6692/KJN.201908_36(2).0002

摘要

不正確的採血過程是影響血液檢體品質的主因。本單位2016年10月檢體退件21件，退件率達0.96%，有逐月增加情形，專案執行期間：2016年11月1日至2017年12月31日分析發現護理人員對檢體採取認知不足與行為不正確、對真空採血流程和採血量不熟悉、真空採血工具放置處未讓護理人員方便拿取使用。專案目的期望每個月血液檢體退件率能低於0.75%以下和護理人員血液採檢認知平均正確率能提升至90%。透過文獻查證、晨會導讀檢體採集作業程序手冊、舉辦血液檢體採檢和安全針具操作在職教育訓練、製作採血順序表等解決辦法；經執行改善方案後檢體退件率可由0.96%降至0.75%以下、護理人員認知平均正確率由72%上升至94.4%，並達到專案目的，使得病人獲得安全有效率的照護品質。

關鍵字

檢體 ； 退件率 ； 血液採檢

並列摘要

Incorrect blood collection process is the main cause of affecting the quality of blood samples. In October 2016, 21 pieces of blood samples were returned in our work unit, and the return rate reached 0.96%, increasing month-by-month. After analysis, it was found that the nursing staff placed insufficient attention on the collection of blood samples, were unfamiliar with the vacuum blood collection process and the amount of blood collection, and the location where the vacuum blood collection lancets placed was not applicable to the nursing staff all the time. Therefore, the purposes of this project were to ameliorate the monthly return rate of blood samples to be less than 0.75% and increase the proper recognition of blood sample collections by the nursing staff to be more than 90%. Through a literature review guiding the procedure manual of the blood sample collection during the morning meeting, conducting the training sessions of techniques of blood sample collection and the manipulation skills of disposable lancet, placing additional disposable lancets in the nursing care facilities, making a standard operating procedure of blood sampling, and formulating examinations of recognition of blood sampling to the nursing staff, all the strategies were able to ameliorate the return rate from 0.96% to less than 0.75%, the proper recognition rate from 72% to 94%, and thereby achieve the purposes of the project. We hope that reducing the return rate of blood samples can make an improvement to patient care quality and patient safety.

並列關鍵字

blood sampling ； return rate ； patient safety

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