運用品管圈的方法降低檢體退檢率

Reducing Specimen Rejection Rate by Applying Quality Control Circle

陳淑珍(Shu-Chen Chen) ； 蕭慧甄(Hui-Chen Hsiao) ； 李津津(Jin-Jin Li) ； 陳虹珍(Hung-Jen Chen) ； 郭怡秀(I-Hsiu Kua) ； 張嘉湖(Jia-Hu Zhang) ； 蔡欣妤(Hsin-Yu Tsai) ； 王紅英(Hung-Ying Wang)

《檢驗及品保雜誌》 2卷4期 (2013/11) Pp. 225-231

https://doi.org/10.6573/JTQA.201311_2(4).08

摘要

臨床檢驗主要提供醫師在治療病患時重要的依據，錯誤的檢驗結果除了影響醫師對症狀判斷，更可能走上醫療糾紛，增加醫院的成本支出及醫療品質滿意度的下降，因此降低不良檢體之退檢率為各家醫院努力達成的目標之一。本文藉由品管圈提出的“降低檢體退檢率”改善主題，透過醫院對個案實際改善的過程與結果來改進醫院對個案之退檢率。本院統計2012年1～3月資料，退檢率為千分之5.3（千分之5.3）；經要因解析後，圈員集思廣義提出「針對護理人員使用真空採檢系統」、「採檢管的認識及注意事項與採檢標準作業流程之在職教育」及「採檢過程中採取2人一組進行採檢作業」的對策，並以週報表的方式及時呈現至各護理單位；對策實施後，由改善前千分之5.3下降至千分之3.7（目標值為千分之4），目標達成率為123.1%、進步率為30.2%。進一步將此三項對策列入標準化作業中，迄2012年11月及12月止，退檢率分別再降為千分之3.0及千分之2.0，顯示運用品管圈方法的效果良好，醫院若能持續維持，將可提昇醫療品質。

關鍵字

品管圈 ； 退檢率

並列摘要

Clinical examination mainly for physicians in the treatment of patients when important evidence, erroneous test results in addition to affecting physicians symptom judgment, are more likely to embark on medical disputes, increased hospital costs and a decline in satisfaction with quality of care, thus reducing bad check the body of the retreat was seized various hospitals strive to achieve one of the goals. In this paper, QCC's ＂lower detection rate of the specimen back＂ theme, the actual cases through hospitals for improving the process and results to improve the hospital's back on the case detection rate. Court statistics from January to March 2012 data, return seized was 5.3 per mille ; through to due analysis, the ring members brainstorming proposed a ＂specimen collection for nurses using a vacuum system＂, ＂specimen collection tubes with knowledge and precautions standard operating procedures for specimen collection service education＂ and ＂specimen collection process to take two pairs for specimen collection operation＂ countermeasures, and weekly reports and timely manner presented to each of the nursing units; countermeasures implemented, improved from 5.3 per mille decreased to 3.7 per mille ( target value 4 per mille), goal achievement was 123.1%, and progress was 30.2%. Further measures included in this three standardized operation, until November 2012 and ended in December, back lower and lower detection rate was 3.0 per mille, respectively, and 2.0 per mille, show the use of QCC method works well, if we continue to maintain the hospital will enhance the quality of care.

並列關鍵字

QC cycle ； specimen rejection rate