[1]张 云,黄新强,高 兴,等.2017年解放军总医院第六医学中心急诊检验质量指标调查与分析[J].现代检验医学杂志,2019,34(03):158-160,164.[doi:10.3969/j.issn.1671-7414.2019.03.041]
　ZHANG Yun,HUANG Xin-qiang,GAO Xing,et al.Investigation and Analysis of Quality Index of Emergency Examinationin Chinese PLA General Hospital Sixth Medical Center in 2017[J].Journal of Modern Laboratory Medicine,2019,34(03):158-160,164.[doi:10.3969/j.issn.1671-7414.2019.03.041]
点击复制

2017年解放军总医院第六医学中心急诊检验质量指标调查与分析()
分享到：

《现代检验医学杂志》[ISSN:/CN:]

卷:
第34卷
期数:
2019年03期
页码:
158-160,164
栏目:
质量控制·实验室管理
出版日期:
2019-06-20

文章信息/Info

Title:
Investigation and Analysis of Quality Index of Emergency Examinationin Chinese PLA General Hospital Sixth Medical Center in 2017
文章编号:
1671-7414(2019)03-158-04
作者:
张 云1; 黄新强1; 高 兴1; 贾翠花2
(1.解放军总医院第六医学中心检验科,北京 100048; 2.河北北方学院医学检验学院,河北张家口 075000)
Author(s):
ZHANG Yun1; HUANG Xin-qiang1; GAO Xing1; JIA Cui-hua2
(1.Department ofClinical Laboratory,Chinese PAL General Hospital-Sixth Medical Center,Beijing 100048,China; 2.College of Medical Laboratory,Hebei North University,Hebei Zhangjiakou 075000,China)
关键词:
质量指标;  质量控制;  实验室;  回顾性分析
分类号:
R446
DOI:
10.3969/j.issn.1671-7414.2019.03.041
文献标志码:
A
摘要:
目的 通过对国家卫生健康委员会下发的临床检验专业质控指标的调查和分析,探讨急诊检验组各质量指标现状和改进效果。方法 收集解放军总医院第六医学中心检验科2017年1～12月期间所有检测标本,回顾性分析检验科和急诊检验组标本类型错误率等8项质量指标的一致性; 分析急诊检验组和常规检验组室内质控开展率等4项质量指标有无统计学差异; 分析急诊检验组申请ISO 15189认可前和准备完成时标本周转时间变化。结果 急诊检验组标本类型错误率等8项质量指标的百分率和σ度量值整体低于检验科平均值,检验科实验室间比对率σ值为3.3处于边缘,而急诊检验组实验室间比对率σ值<3.0为不可接受; 与常规检验组比较,急诊检验组室内质控开展率和室内质控项目变异系数不合格率差异无统计学意义(χ2=2.796,P=0.095; χ2=0.857,P=0.354),室间质评项目不合格率差异有统计学意义(χ2=6.287,P=0.012),室间质评项目参加率差异有显著性统计学意义(χ2=30.059,P=0.000); 标本检验前周转时间第四季度整体优于第一季度,血气、凝血和血细胞检测实验室内周转时间无差异。结论 对急诊检验组14项质量指标调查分析,能够发现实验室质量缺陷,且分专业评估能够避免统一汇总带来的抵消或趋从现象,从而达到检验科质量体系持续改进的目的。
Abstract:
Objective To investigate and analyze the quality control indicators of the clinical laboratory issued by the National Health Commission of the People's Republic of China,and discuss the current status ofthe quality indicators of the emergency examination and the improvement results.Methods All specimens from January to December in 2017were collected from the Department of Clinical Laboratory of Chinese PLA GeneralHospital Sixth Medical Center.The consistency of eight quality indicators suchas the error rate of the specimens in the department of clinical laboratory andthe emergency department was analyzed retrospectively.Whether there were statistical differences in the 4 quality indicators,such as internal quality controldevelopment rate,and analysis of changes in the specimen turnaround time before and after the emergency department prepares to apply for ISO 15189 accreditation.Results The percentages of 8 quality indicators suchas the error rate of specimens in the emergency examination department and theσ measurement were generally lower than the average of the laboratory subjects.The marginal σ value of the laboratory subjects was 3.3 percent,while unacceptable σ value of emergency department was below 3.0 percent.Compared with the routine examination department,there was no significant difference in the development rate and CV% failure rate of internal quality control(χ2=2.796,P=0.095; χ2=0.857,P=0.354),there was statistically difference inthe pass rate of external quality control(χ2=6.287,P=0.012),and there was significant statistical difference in the participation rate of external quality control(χ2=30.059,P=0.000).The specimens turnaround time before test was better in the fourth quarter than in the first quarter,blood gas analysis specimens,blood coagulation specimens and blood routine analysis specimens no difference in turnaround time in the laboratory.Conclusion Through investigation and analysis of 14 quality indicators of the emergency examination department,it is possible to find laboratory quality defects,and the professional evaluation can avoid the phenomenon of offset or compliance caused by the unified summary,so as to achieve the purpose of continuous improvement of the quality system of the laboratory.

参考文献/References:

[1] College of American Pathologists.About Q-Probes [EB/OL].(2013-02-18)[2013-07-17].http://www.cap.org/cap.protal.
[2] ZARBO R J,JONES B A,FRIEDBERG R C,et al.Q-tracks:a Collegeof American Pathologists program of continuous laboratory monitoring and longitudinal tracking[J].Arch Pathol Lab Med,2002,126(9):1036-1044.
[3] International Organization For Standardization. ISO 15189:2012.Medicallaboratories-requrirements for quality and competence(3rd ed)[S].Geneva:Switzerland,ISO15189,2012.
[4] 国家卫生计生委.临床检验专业医疗质量控制指标(2015版)[S].北京:中国标准出版社,2015. National Health and Family Planning Commission.Clinical laboratoryquality indicators(2015 edition)[S].Beijing:China Standard Press,2015.
[5] FRASER C G,HYLTOFT PETERSEN P,LIBEER J C,et al.Proposals for settinggenerally applicable quality goals solely based on biology[J].Ann Clin Biochem,1997,34(Pt 1):8-12.
[6] 王治国.临床检验6σ质量设计与控制[M].北京:人民卫生出版社,2012. WANG Zhiguo.Clinical laboratory 6σ quality design and control[M].Beijing:People's Health Publishing House,2012.
[7] 段敏,赵海建,王薇,等.IFCC关于临床检验之外阶段质量指标与实验室性能的讨论[J].现代检验医学杂志,2018,33(1):1-4. DUAN Min,ZHAO Haijian,WANG Wei,et al.Discussions about extra-analytical quality indicators and laboratory performances by IFCC[J].Journal ofModern Laboratory Medicine,2018,33(1):1-4.
[8] 费阳,王薇,王治国.临床检验室内质量控制规则设计新工具-Westgard西格玛规则[J].现代检验医学杂志,2015,30(1):149-152. FEI Yang,WANG Wei,WANG Zhiguo.A new internal quality control rules design tool in clinical laboratory Westgard sigma rules[J].Journal of Modern Laboratory Medicine,2015,30(1):149-152.
[9] 章晓燕,王薇,王治国,等.基于西格玛度量优化临床检验风险分析质量控制计划[J].现代检验医学杂志,2016,31(4):154-156,158. ZHANG Xiaoyan,WANG Wei,WANG Zhiguo,et al.Prioritizing risk analysis quality control plan based on sigma-metrics[J].Journal of Modern Laboratory Medicine,2016,31(4):154-156,158.
[10] 郦卫星,王治国,康凤凤,等.浙江省15项临床检验质量指标调查结果与分析[J].中华检验医学杂志,2016,39(1):23-28.LI Weixing,WANG Zhiguo,KANG Fengfeng,et al.Analysis of 15 quality indicators in clinical laboratory in Zhejiang province[J].Chinese Journal of Laboratory Medicine,2016,39(1):23-28.
[11] 杨雪,王治国.检验医学分析前的差错类型与防范[J].中华医院管理杂志,2013,29(1):31-34.YANG Xue, WANG Zhiguo. Types of errors and prevention before medical analysis[J].Chinese Journal of Hospital Administration,2013,29(1):31-34.

相似文献/References:

[1]费 阳,王 薇,王治国.医学检验质量指标:质量和患者安全的基本工具[J].现代检验医学杂志,2015,30(04):1.[doi:10.3969/j.issn.1671-7414.2015.04.001]
　FEI Yang,WANG Wei,WANG Zhi-guo.Quality Indicators in Laboratory Medicine:A Fundamental Tool for Quality and Patient Safety[J].Journal of Modern Laboratory Medicine,2015,30(03):1.[doi:10.3969/j.issn.1671-7414.2015.04.001]
[2]何法霖,王 薇,钟 堃,等.血红蛋白A2和F的室间质量评价结果分析[J].现代检验医学杂志,2015,30(02):156.[doi:10.3969/j.issn.1671-7414.2015.02.050]
　HE Fa-lin,WANG Wei,ZHONG Kun,et al.External Quality Assessment of Hemoglobin A2(HbA2) and Hemoglobin F(HbF)Measurement[J].Journal of Modern Laboratory Medicine,2015,30(03):156.[doi:10.3969/j.issn.1671-7414.2015.02.050]
[3]何法霖,王 薇,钟 堃,等.2015年全国中孕期母血清产前筛查相关指标的调查与分析[J].现代检验医学杂志,2017,32(01):154.[doi:10.3969/j.issn.1671-7414.2017.01.043]
　HE Fa-lin,WANG Wei,ZHONG Kun,et al.Survey and Analysis for Maternal Serum Marker of Prenatal Screening in Second Trimester in 2015[J].Journal of Modern Laboratory Medicine,2017,32(03):154.[doi:10.3969/j.issn.1671-7414.2017.01.043]
[4]李婷婷,赵海建,王 薇,等.京津冀地区56家临床检验结果互认实验室18个常规化学项目参考区间结果分析[J].现代检验医学杂志,2017,32(06):154.[doi:10.3969/j.issn.1671-7414.2017.06.001]
　LI Ting-ting,ZHAO Hai-jian,WANG Wei,et al.Analysis of Reference Intervals of 18 Routine Biochemistry in 56 Mutual Recognition Laboratories in Beijing-Tianjing-Hebei Region[J].Journal of Modern Laboratory Medicine,2017,32(03):154.[doi:10.3969/j.issn.1671-7414.2017.06.001]
[5]何法霖,王 薇,钟 堃,等.我国中孕期产前筛查不同检测系统室内质量控制现状与行业标准的比较[J].现代检验医学杂志,2018,33(01):154.[doi:10.3969/j.issn.1671-7414.2018.01.001]
　HE Fa-lin,WANG Wei,ZHONG Kun,et al.Comparison of the Status of Internal Quality Control and Industry Standard of Different Platforms for Second Trimester Prenatal Screening in China[J].Journal of Modern Laboratory Medicine,2018,33(03):154.[doi:10.3969/j.issn.1671-7414.2018.01.001]
[6]梁 婧,罗 虎,李隆飞,等.西格玛管理在职业健康体检血细胞分析检测质量控制中的应用[J].现代检验医学杂志,2018,33(02):151.[doi:10.3969/j.issn.1671-7414.2018.02.001]
　LIANG Jing,LUO Hu,LI Long-fei,et al.Application of Sigma Management in Quality Control of Blood Cell for Occupational Health Examination[J].Journal of Modern Laboratory Medicine,2018,33(03):151.[doi:10.3969/j.issn.1671-7414.2018.02.001]
[7]郝庆钦,高 云,许友山,等.β2-微球蛋白血清质控物的制备及评价[J].现代检验医学杂志,2018,33(02):154.[doi:10.3969/j.issn.1671-7414.2018.02.001]
　HAO Qing-qin,GAO Yun,XU You-shan,et al.Preparation and Evaluation of the Serum Quality Control Material of β2-Microglobulin[J].Journal of Modern Laboratory Medicine,2018,33(03):154.[doi:10.3969/j.issn.1671-7414.2018.02.001]
[8]叶圆圆,王 薇,赵海建,等.中国临床实验室标本可接受性质量指标室间质量调查研究[J].现代检验医学杂志,2018,33(02):134.[doi:10.3969/j.issn.1671-7414.2018.02.001]
　YE Yuan-yuan,WANG Wei,ZHAO Hai-jian,et al.External Quality Analysis of Quality Indicators on Specimen Acceptability[J].Journal of Modern Laboratory Medicine,2018,33(03):134.[doi:10.3969/j.issn.1671-7414.2018.02.001]
[9]王 辉,徐克和,唐书强,等.临床化学实验室质量控制计算实际西格玛值的新方法[J].现代检验医学杂志,2019,34(02):132.[doi:10.3969/j.issn.1671-7414.2019.02.034]
　WANG Hui,XU Ke-he,TANG Shu-qiang,et al.New Method for Calculating the Actual Sigma Metricsin Clinical Chemistry Laboratory Quality Control[J].Journal of Modern Laboratory Medicine,2019,34(03):132.[doi:10.3969/j.issn.1671-7414.2019.02.034]
[10]谢小娟a,郭　华b,李小侠b,等.陕西省临床实验室检验标本可接受性质量指标统计分析[J].现代检验医学杂志,2019,34(06):148.[doi:10.3969 ／ j.issn.1671-7414.2019.06.038]
　XIE Xiao-juana,GUO Huab,LI Xiao-xiab,et al.Investigation and Analysis on Quality Indicators of Acceptability of Clinical Test Specimens in Shaanxi Province[J].Journal of Modern Laboratory Medicine,2019,34(03):148.[doi:10.3969 ／ j.issn.1671-7414.2019.06.038]

备注/Memo

备注/Memo:
作者简介:张 云(1980-),男,本科,主管技师,主要从事急诊检验工作,E-mail:ayun359@sohu.com。 收稿日期:2018-06-11 修回日期:2019-03-10
更新日期/Last Update: 2019-06-20