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目的对急诊红细胞输注申请的结果报告时间(turnaround time,TAT)进行监测,了解影响急诊输血申请TAT的因素,促进输血科持续质量改进,同时为制定急诊输血处理流程提供依据。方法观察各个临床科室急诊红细胞输注从医生开出输血申请到合血标本采集、标本运送、标本检测不同时间段所占的时间,找出影响标本处理总时间的因素,计算输血科处理急诊标本的平均时间。结果从临床开出输血申请到输血科完成交叉合血(总TAT),中位数时间为138 min,最短为17 min。从输血申请送到输血科到完成交叉合血,中位数时间为55 min。从开出输血申请到血液取用,中位数时间为221 min,最短为21 min,最长为4 266 min(71 h)。所有急诊红细胞输注申请中,约有70%的红细胞被取回输注,交叉合血:输血比例为1.4∶1。随着总TAT时间的延长,标本采集时间和标本运送时间所占比例逐渐下降,而标本检测时间所占比例逐渐上升。结论目前将急诊输血取血时间定为1 h较为符合实际情况;部分临床医生开急诊输血申请较为随意;输血科对部分急诊标本处理不够及时。
Objective To monitor the turnaround time (TAT) of emergency red blood cell transfusion (RBC) transfusion, to understand the factors influencing the application of emergency transfusion TAT, to promote the continuous quality improvement of blood transfusion department and to provide the basis for the development of emergency blood transfusion process. Methods Observe the time of transfusion of red blood cells from emergency department to collection of blood samples, delivery of specimens, detection of specimens in different time periods, find out the factors that affect the total time of specimen processing, calculate the emergency transfusion specimens The average time. Results From the clinical application of blood transfusion to transfusion department to complete cross-conjoint blood (total TAT), the median time was 138 min, the shortest was 17 min. From the transfusion request to the blood transfusion department to complete the cross-conjoint blood, the median time was 55 min. From the application of blood transfusion to blood access, the median time was 221 min, the shortest was 21 min and the maximum was 4 266 min (71 h). About 70% of all RBC transfusions were taken for infusion, and the cross-stained blood was transfused in a ratio of 1.4: 1. With the extension of the total TAT, the proportion of specimen collection time and specimen delivery time gradually decreased while the proportion of specimen detection time gradually increased. Conclusions At present, it is in line with the actual situation that the blood transfusion time of emergency transfusion should be 1 h; some clinicians are more willing to apply for emergency transfusion; and the blood transfusion department does not handle some emergency samples promptly.