降低移植加護病房血液檢體不良率

Reduction of Unqualified-Blood-Samples Incidence Rate in Transplant Intensive Care Unit

10.6200/TCMJ.2014.11.1.09

張品嫻(Pin-Hsien Chang)；陳雅玲(Ya-Ling Chen)；邱綉玲(Hsiu-Ling Chiu)；林梅香(Mei-Hsiang Lin)；蔡佩臻(Pei-Jen Tsai)

血液檢體不良 ； 肝臟移植 ； 溶血 ； abnormal blood sample ； liver transplant ； Hemolysis

北市醫學雜誌

11卷1期（2014 / 03 / 30）

87 - 97

繁體中文

肝臟移植手術後因血液動力學不穩定需密切監控，正確迅速的血液檢驗結果是臨床診斷治療與用藥的重要依據。本單位2012年1~3月血液檢體不良率0.8%、護理人員執行血液檢體採集正確率64.7%，血液檢體採集認知正確率70.8%，相關設備上亦有不足。經由檢討血液採檢流程、設計試管直立架、增加採血順序提醒工具及舉辦教育訓練方式等介入措施，改善後血液檢體不良率0.28%；護理人員執行血液檢體採集正確性96.7%（提升32%）；血液檢體採集認知正確率由70.8% 上升至94.2%，達專案改善目標，使病人獲得安全有效率的照護品質。

Due to hemodynamic instability after liver transplantation, rapid and correct hematological examinations are essential to proper diagnosis, treatment and medication. The abnormal rate of blood samples in our ICU from January 2012 to March 2012 was 0.8%; the correct rate of blood sample collected by nurse was 64.7%. The accuracy of acknowledge about blood sample collection was 70.8%. Also, the equipments were insufficient. The interventions included (1) review of blood sample collecting procedures, (1) increasing upright tube storage, and (3) alerting pictures of blood collecting and arranging the education. As a result, the abnormal rate of blood sample decreased to 0.28%, the accuracy of collecting blood sample increased from 64.7% to 96.7%, and the accuracy of acknowledge about blood sample collection increased from 70.8% to 94.2%. This project had reached its goals in improving care efficacy and patient safety.