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目的通过调查标本不合格现状,了解检验标本分析前质量现存问题。针对存在的质量问题,应用质量持续改进方法,总结质量持续改进在降低检验标本分析前质量不合格率中的实施效果。方法收集2015年7—9月不合格标本资料并统计分析,了解检验标本分析前质量的控制现状,运用质量管理工具进行解析,确定其根本原因,并制定改进措施,对实施后的效果进行追踪验证。收集2016年1—3月不合格标本资料,运用统计学方法比较实施措施前后不合格标本率有无差异,判定改进效果,根据此实施效果,调整对策后再对2016年4—5月实施效果进行追踪。结果质量持续改进活动前标本不合格率为6.0398‰,实施干预措施后,标本不合格率为3.6039‰,再次改进后标本不合格率为2.8988‰,不合格率明显下降,差异有统计学意义(P<0.05)。结论建立多部门合作体系,改善流程,进行环节控制,完善各部门间的沟通与交接,加强培训,是有效做好检验标本分析前质量控制的关键所在,护理部、检验、后勤、采供等多部门协同管理和质量持续改进活动有效的提高了检验标本分析前质量。
Objective To investigate the existing problems in the quality of pre-test specimens by investigating the current status of specimens failed. For the existing quality problems, applying the method of continuous improvement of quality, summarizing the implementation effect of continuous improvement of quality in reducing the unqualified rate of quality before the test specimen analysis. Methods The data of non-conformities from July to September in 2015 were collected and analyzed statistically to understand the status quo of quality control before test sample analysis, analyze with quality management tools, determine the root cause and make corrective measures to track the effect after implementation verification. Collect unqualified specimen data from January to March, 2016, use statistical method to compare whether there is difference in unqualified specimen rate before and after implementing measures, and judge the improvement effect; according to the implementation effect, adjust the countermeasure before implementing the effect from April to May, 2016 Follow up. Results of the continuous improvement of quality before the sample failed rate of 6.0398 ‰, the implementation of interventions, the sample failed rate of 3.6039 ‰, again improved the sample failed rate of 2.8988 ‰, the failure rate decreased significantly, the difference was statistically significant ( P <0.05). Conclusion The establishment of a multi-sectoral cooperation system, improvement of processes, control of links, improvement of communication and handover among various departments, and strengthening of training are the keys to effectively carrying out quality control before testing specimen analysis. Nursing department, inspection, logistics, procurement and supply etc. Multisectoral collaborative management and continuous quality improvement activities effectively improve the quality of pre-test specimens.