降低病房檢體退檢率

Reducing the Rejection Rate of Impatient Specimens

吳筱芸(Siou-Yun Wu) ； 陳香伶(Hsiang-Ling Chen) ； 林怡嘉(Yi-Jia Lin) ； 林淑女(Shu-Nju Lin) ； 李沛潔(Pei-Jie Lee) ； 林偉傑(Wei-Jie Lin)

《寶建醫護與管理雜誌》 9卷2期 (2011/12) Pp. 23-36

https://doi.org/10.29681/PCJHM.201112.0004

摘要

本專案的目的在降低病房檢體退檢率，檢驗科於99年6月統計報表中發現病房檢體退檢數偏高，退檢率為3.02%，專案小組深入探討發現問題導因為（一）護理人員習慣不佳，未確實執行檢體送檢流程及檢體送檢前之核對作業。（二）護理人員檢體採樣專業知識不足。（三）病人血管太細抽血不容易造成檢體clot（四）未建立不良檢體指標監測，持續性評估不良檢體發生退檢情況與發生單位。經本專案組員共同採用解決活動為（一）製作檢體送出前核對提醒卡，提醒傳送員與護理人員多次核對，減少因人為疏失造成不良檢體之發生（二）製作採血標準流程圖及檢體採樣辨識步驟海報，加強提醒護理人員採樣知識與技術（三）製作預防檢體溶血及clot注意事項海報，隨時提醒護理人員注意（四）制定不良檢體指標監測制度及建立獎勵辦法，改善團隊間合作氣氛。經本專案實施後，病房檢體退檢率由3.02%降至1.98%，耗損成本改善幅度達27.6%，不但提升檢驗品質與工作效率，也降低了機構成本浪費，更加維持團隊間之良性合作氣氛。

關鍵字

不良檢體 ； 檢體退檢率 ； 檢驗品質

並列摘要

Purpose of this project was to find ways of reducing rejection rate of impatient specimens. The laboratory of the case hospital found the rejection rates from the impatient department (IPD) were as high as 3.02% from the record. Problems were identified as (1) The nurses ingored the standard operation procedures, (2) IPD nurses lacked sampling knowledge, (3) sample clots, (4) indicator for abnormal specimen was absent. Alternative for the problems were (1) Establish a notice card to remind a careful checking before delivering to the lab, (2) establish a stnadrad chart of blood picking associated with detailed illustration of specimen sampling, (3) produce a poster to remind avoinding hematolysis and clot, (4) an incentive program to encourage cross-department cooperations. The paorject successfully reduce the rejection rate to 1.98% with cost saving at 27.6%. This had not increase the effectiveness and efficiency of service quality but also improve the organizational atmosphere among the iPD and the lab.

並列關鍵字

Bad test specimen ； Rejection rate ； Test quality