【摘要】 目的 分析长沙市辖区各医疗机构临床用血管理现状,为输血科(血库)建设与临床输血管理提供决策依据。方法 依据《湖南省医疗机构输血科(血库)建设基本标准》,对2017—2020年曾临床用血的163家医疗机构,通过查阅文件、现场查看的方式,督查医疗机构的输血机构设置、输血专职专业技术人员配备、设施配备及业务开展情况等,并对输血病历进行考核评价。结果 接受检查的163家医疗机构包括三级医院33家、二级医院49家、一级医院81家。三级医院具有输血专职专业技术资格的人员共210人,二级医院有111人,一级医院有208人。36.4%(12/33)的三级医院独立设置了输血科,仅8.2%(4/49)的二级医院独立设置了输血科,一级医院未独立设置输血科。三级医院开展抗体效价检测、直接或间接抗球蛋白试验、血栓弹力图、自体输血、血小板抗体检测的分别占84.8%、90.9%、24.2%、30.3%、45.5%。二级医院开展抗体效价检测、直接或间接抗球蛋白试验分别占6.1%、81.6%。二级和一级医院未开展血栓弹力图、自体输血、血小板抗体检测。输血病历记录主要存在以下不规范情况(占比>2.0%):输血过程记录不详细、输血过程护理记录不全、《输血申请单》记录不完整、输血不良反应未上报。三级医院临床输血病历记录较二级及一级医院规范。结论 长沙市辖区三级医院输血科管理及输血病历记录普遍较好,输血专职人员配备较一、二级医院充足,一、二级医院基本能较规范地开展临床输血工作,但部分一、二级医院输血病历记录存在以下主要不规范情况(占比>2.0%):输血过程记录不详细、输血过程护理记录不全、《输血申请单》记录不完整、输血不良反应未上报。更多还原

【Abstract】 Objective To analyze the current status of clinical blood management in various medical institutions in the jurisdiction of Changsha City,and to provide decision-making basis for the construction of blood transfusion department(blood bank) and clinical blood transfusion management.Methods According to the "Basic Standards for the Construction of Blood Transfusion Department(Blood Bank) in Medical Institutions in Hunan Province".The 163 medical institutions that used blood clinically from 2017 to 2020.By consulting documents and on-site inspections,supervise the setting of blood transfusion institutions,the allocation of professional and technical personnel for blood transfusion,equipment allocation and business development of medical institutions.And evaluate and evaluate the blood transfusion medical records.Results The 163 medical institutions examined included 33 tertiary hospitals,49 secondary hospitals,and 81 primary hospitals.210 people in tertiary hospitals with full-time professional and technical qualifications for blood transfusion,111 in second-level hospitals,and 208 in first-level hospitals.36.4%(12/33) of the tertiary hospitals had independently set up blood transfusion departments,only 8.2%(4/49) of the second-level hospitals had independently set up blood transfusion departments,and the first-level hospitals had not independently set up blood transfusion departments.Tertiary hospitals carry out antibody titer testing,direct or indirect antiglobulin test,thromboelastography,autotransfusion,and platelet antibody testing accounted for 84.8%,90.9%,24.2%,30.3%,and 45.5%,respectively.Secondary hospitals carried out antibody titer testing and direct or indirect antiglobulin testing accounted for 6.1% and 81.6% respectively.Thromboelastography,autotransfusion,and platelet antibody testing have not been carried out in the secondary and primary hospitals.The following irregularities in the blood transfusion medical records(accounting for>2.0%):incomplete blood transfusion process records,incomplete blood transfusion care records,incomplete records in the "Blood Transfusion Request Form",and unreported adverse blood transfusion reactions.The clinical records of blood transfusion in tertiary hospitals are more standardized than those in secondary and first-level hospitals.Conclusion The blood transfusion department management and blood transfusion record records of tertiary hospitals in Changsha City are generally better.The full-time staffing of blood transfusion is more sufficient than that of primary and secondary hospitals.Primary and secondary hospitals can basically carry out clinical blood transfusion work in a more standardized manner.However,some primary and secondary hospitals have the following major irregularities in the blood transfusion medical records(accounting for>2.0%):incomplete blood transfusion process records,incomplete blood transfusion process nursing records,incomplete records of the "Blood Transfusion Application Form",and unreported adverse blood transfusion reactions.更多还原