摘要
目的 通过对医疗机构临床实验室的基本情况及15项临床检验质量指标的调查,了解青海省临床检验的质量现状.方法 2016年4月,青海省临床检验中心利用临床检验室间质量评价信息管理系统（Clinet-EQA）软件平台,向青海省106家医疗机构临床实验室发放电子调查表,在线收集调查结果.医疗机构及实验室的基本信息和15项质量指标调查结果的统计分析采用Clinet-EQA系统的软件结合SPSS 13.0,并将13项以率表示的质量指标转换为西格玛（σ）度量值进行评价.结果 102家医疗机构临床实验室回报了结果,回报率为96.2%.8/13项质量指标总体σ水平〉3σ.代表样本可接受性的标本类型错误率、容器错误率、采集量错误率、抗凝标本错误率平均σ水平略低于与全国水平.在这4项指标上,青海省各等级医院与全国同等级医院比较,二级医院在生化、免疫、临检、微生物4个专业中的数据水平优于三级医院.常规生化和免疫的检验前周转时间（TAT）平均水平为50 min,三大常规（血尿便）和凝血试验为45 min,急诊检验为15 min;实验室内TAT的平均水平,生化时间最长,分别为常规检验的120 min和急诊检验的40 min.三大常规（血尿便）实验室内常规检验TAT中位数时间平均水平,青海省明显长于全国.以生化专业为例,不同等级医院实验室常规检验TAT检验前（P=0.007,P〈0.05）和实验室内（P=0.040,P〈0.05）差异有统计学意义,而急诊检验TAT检验前（P=0.171,P〉0.05）和实验室内（P=0.067,P〉0.05）差异无统计学意义.结论 青海省13项以率表示的质量指标平均水平有4项低于全国,三大常规（血尿便）实验室内常规检验的TAT水平也低于全国水平,实验室应针对薄弱环节,持续改进,提高检验质量.
Objective To investigate the basic status and the 15 quality indicators in clinical laboratory of medical institutionin in Qinghai provinces, and to understand the quality status.Methods Clinet-EQA system was applied by Qinghai Center for Clinical Laboratories to provide the electronic questionnaire for the clinical laboratory of 106 medical institutions in April 2016 and report related results online.The software of Clinet-EQA system and SPSS13.0 were used for 15 quality indicators for statiatical analysis,13 indicators expressed in rate were further evaluated with sigma scales.Results Totally 102 laboratories returned questionnaires, the rate was of 96.2%.8/13 quality indicators of the overall sigma levels were all 〉3.The average level of 4 quality indicators such as the sample type error rate was slightly lower than the national.Comparison of the 4 quality indicators of each grade hospital in Qinghai and the same grade hospital in the national, secondary hospital in clinical chemistry, immunology, clinical examination,microbiology in the four major performed better than tertiary hospital.In routine examination, pre-analytical TAT average level of clinical chemistry and immunology was about 50 min,and of blood,urine and stool was 45 min.Pre-analytical TAT in emergency examination for all four disciplines were about 15 min.Intra-analytical TAT for clinical chemistry was the longest,which was 120 min for routine examination and 40 min for emergency examination,respectiely.The average level of the median TAT of blood,urine and stool in routine examination of Intra-analytical in Qinghai was longer than the national.For example of clinical chemistry, routine examination both in pre-analytical TAT and in Intra-analytical TAT was statistically significant in different scales of laboratories,and emergency examination in pre-analytical TAT and in Intra-analytical TAT was not statistically significant.Conclusions 4/13 quality indicators which expressed in rate in the average level in Qinghai province were lower than the national,the average level of the median TAT of blood,urine and stool in routine examination of Intra-analytical in Qinghai was longer than the national.The laboratory should focus on the weak links and continue improvement.
出处
《中华检验医学杂志》
CAS
CSCD
北大核心
2017年第11期885-889,共5页
Chinese Journal of Laboratory Medicine
关键词
实验室
调查
质量指标
Laboratory
Investigation
Quality indicators
