降低健康管理中心檢體退檢率

To Reduce The Specimen Rejection Rate in a Health Management Center

10.6530/YYN.202103_15(1).0005

胡素儒(Su-Ju Hu)；吳麗娟(Li-Jiuan Wu)；韋岭岄(Lin-Yueh Wei)；陳瑞芳(Juei-Fang Chen)；王郁華(Yu-Hua Wang)；林佳慧(Chia-Huei Lin)

檢體 ； 退檢率 ； 護理 ； specimen ； rejection rate of specimens ； nursing

源遠護理

15卷1期（2021 / 03 / 01）

30 - 39

繁體中文

檢體採檢結果乃協助醫師快速診斷及正確治療的重要依據。2016年10－12月本中心血液檢體退檢率高達1.41％，引發專案小組改善動機，目的在降低健康管理中心血液檢體退檢率。根據現況分析主要問題為：未落實血液檢體採檢作業流程、血液檢體採檢及溶血相關認知教育訓練不足、檢體條碼標籤未全面資訊化。經文獻查證及團隊討論後，擬定解決辦法，進行教育訓練、設計血液檢體採檢相關工具、血液檢體採檢流程光碟、建立檢體標籤條碼資訊化。專案實施結果發現血液檢體退檢率由1.41％降至0.08％；血液檢體採檢正確率由73.1％提升至98.1％，顯示此專案能強化護理師執行血液檢體採檢之正確性，有效降低血液檢體退檢率，以達到安全的就醫環境。

Accurate blood test results are imperative for physicians to make timely diagnosis and treatment decisions. The blood specimen rejection rate of the studied health management center was 1.41% during the 4th quarter 2016. A project improvement team formed aiming to lower the blood specimen rejection rate. Assessment of the practice situation revealed the causes of this high rejection rate included: lack of professional knowledge, inappropriate blood withdrawal procedures, hemolysis-related problems, and lack of barcode labeling on the specimen. After literature review and team discussions, the team developed a staff training programs, a blood withdrawal checklist, a multimedia disc to standardize blood withdrawal procedures, and a specimen barcode labeling system. After the implementation of the strategies, the blood specimen rejection rate reduced from 1.41% to 0.08% and the correct blood specimen collection rate increased from 73.1% to 98.1%. The project was effective in the improvement of patient safety in the medical facility.

1. 吳雪紅,魏玉芳,闞秋萍,李淑燕,林佳慧(2015)。降低手術檢體退件率。源遠護理，9(1)，37-44。
   連結：
2. 汪美玲,黃淑芬,林姿秀(2015)。應用品質突破模式降低內科病房血液檢體異常退件率。長庚護理雜誌，27(3)，391-401。
   連結：
3. 周娟羽,徐淑珠,楊媗羽,郭美玲,陳淑華(2016)。降低手術檢體退件率之專案。長庚護理雜誌，27(2)，209-219。
   連結：
4. D’Angelo, R.,Mejabi, O.(2016).Getting it right for patient safety: Specimen collection process improvement from operating room to pathology.American Journal of Clinical Pathology,146(1),8-17.
5. Dikmen, Z. G.,Pinar, A.,Akbiyik, F.(2015).Specimen rejection in laboratory medicine: Necessary for patient safety?.Biochemistry of Medicine,25(3),377-385.
6. Incilay, S. L.,Aslı, P.,Filiz, A.(2014).Classification of reasons for rejection of biological specimens based on pre-preanalytical processes to identify quality indicators at a university hospital clinical laboratory in Turkey.Clinical Biochemistry,47(12),1002-1005.
7. Joint Commission on Accreditation of Healthcare Organizations (2015). National Patient Safety Goal. Retrieved from http//www.jointcommission.org/standardsinformation_/npsgs.Aspx
8. Lee, N. Y.(2019).Reduction of pre-analytical errors in the clinical laboratory at the University Hospital of Korea through quality improvement activities.Clinical Biochemistry,70,24-29.
9. Park, W. B.,Myung, S. J.,Oh, M.,Lee, J.,Kim, N. J.,Kim, E. C.,Park, J. S.(2015).Educational intervention as an effective step for reducing blood culture contamination: A prospective cohort study.Journal of Hospital Infection,91(2),111-116.
10. 李佳芳,葉筱鳳,林琪馨(2015)。降低某醫學中心外科加護病房血液檢體退件率之改善案。澄清醫護管理雜誌，11(3)，54-65。
11. 財團法人全國認證基金會（2019）．實驗室認證認校正／測試／檢驗認證規範與評鑑範圍說明．取自https://www.taftw.org.tw/wSite/sp?xdUrl=/wSite/taf/list_doc.jsp?ACC_ID=IB_ID&mp=1
12. 張品嫻,陳雅玲,邱綉玲,林梅香,蔡佩蓁(2014)。降低移植加護病房血液檢體不良率。北市醫學雜誌，11(1)，87-91。
13. 黃珮琪,莊靜娟,陳婉宜(2015)。降低肝臟移植病房檢體退件率之改善專案。長庚護理，25(4)，424-437。
14. 衛生福利部（2015）．105-106年度醫院病人安全工作目標及執行策略．取自http://www.drwuhospital.com.tw/download/105-106_PS.pdf

1. (2024)。改善內科加護病房血液檢體重送率。榮總護理，41(3)，248-257。