剔除、合併、重排、簡化（ECRS）手法縮短新生兒加護病房共管備血時間

Elimination, Combination, Rearrangement and Simplification (ECRS) Skills Shorten the Blood Preparation Time in Sharing Specimen in Neonatal Intensive Care Unit

侯玉純(Yu-Chun Hou) ； 林素美(Su-Mei Lin) ； 陳瓊汝(Chiung-Ju Chen) ； 徐金民(Chin-Min Hsu) ； 楊慶晨(Ching-Chen Yang) ； 簡淑珍(Shu-Zhen Chien) ； 廖佳慧(Chia-Hui Liao) ； 鄭瑞楠(Jui-Nan Cheng) ； 簡惠萍(Hui-Ping Chien)

《台灣醫學》 24卷5期 (2020/09) Pp. 567-575

https://doi.org/10.6320/FJM.202009_24(5).0011

摘要

本專案是以ECRS（剔除、合併、重排、簡化）品管手法，重新檢討及改造新生兒加護病房共管備血作業，目的在於重整及簡化共管備血作業內容及流程，提升新生兒加護病房共管備血效率，保障病患用血安全，發揮輸血之最大效益。共管檢體會先送血液組進行常規檢查，若需備血，則呼叫傳送員將檢體送回病房，重新貼上備血標籤，由採檢者及見證者兩人共同核對後送血庫備血，此過程多次往返耗時，延誤備血輸血作業，故如何提升共管備血時效成為重要議題。2019年7月由檢驗科血液、血庫組、新生兒加護病房及事務課共同組成品管圈，透過ECRS手法分析，並擬定具體化對策實施後，共管備血總時間由改善前158.0分鐘縮短至104.6分鐘，目標達成率144.7％，經過效果確認並納入標準化作業。

關鍵字

品管圈 ； 新生兒加護病房 ； 共管備血 ； 雙人核對 ； ECRS

並列摘要

This project uses the ECRS (elimination, combination, rearrangement, and simplification) quality control method to review and improve the blood preparation by sharing specimen in neonatal intensive care unit (NICU). The purpose is to reform and simplify the content and process of blood preparation in NICU, and protect patients' blood safety and maximize the benefits of blood transfusion. The blood specimens were shared between the hematology laboratory for routine examination and the blood bank for blood preparation. If blood preparation is required, the specimen in the hematology laboratory will be retrieved to the NICU, relabeled through a double-check by the collector and the witnesses, and sent to the blood bank for blood preparation. The multiple delivering process is time-consuming, and will delay blood preparation and transfusion. Therefore, how to improve the blood preparation time of the NICU by improving the process is an important issue. In July 2019, the quality control circle was formed by the hematology laboratory, blood bank, NICU and affairs department. After applying the ECRS approach to optimizing the process, the total time of blood preparation in the NICU was reduced from 158.0 minutes to 104.6 minutes, equal to 144.7% target achieving rate. The process was afterwards included in the standard operation procedure.

並列關鍵字

quality control circle ； neonatal intensive care unit ； sharing specimen with blood preparation ； double check ； ECRS

參考文獻

花雀惠、廖儷祝、莊麗婷、洪啟偉、陳啟芳、謝月貞：以ECRS思維建置實驗室表單電子化之效益。醫務管理期刊，2015。

Chen IC, Kuo MH. Quality improve¬ment: perspectives on organizational learning from hospital-based quality control circles in Taiwan. Human Resource Development International, 2011.

Mark Brecher: Technical Manual, 15th ed. AABB, 2005.

張建斐、翁睿廷、蔡易璋、陳盈谷、廖英傑、林松茂、侯欽德：QC七大手法及問題分析與解決：企業持續改善的基本課題。中國生產力中心，2014。

許國敏、劉淳儀、白淑芬：醫療品管的深耕活動：醫療界的QCC實務。台灣：中衛，2011。