摘要
目的识别尿细菌培养检验过程中的潜在风险,对于高、中风险点进行管理、控制、优化和效果评估,为临床提供更准确、及时的结果。方法在尿细菌培养检验前、检验中及检验后,从"人(人员),机(设备)、料(材料)、法(方法)、环(环境)"等要素中识别可能影响尿细菌培养检验结果的潜在风险,并根据风险的严重程度、发生的概率用探测度进行程度分级,然后对不可接受的风险和需要采取措施降低的风险进行管理。结果在尿培养的10个检验过程中未发现不可接受风险,只是识别出需采取措施降低的风险3项,涉及检验前的标本采集(护士操作不规范、无菌管被污染)、检验中的标本处理(无菌操作不规范、未及时处理)和培养结果的判读(细菌识别错误)五大要因。对这些潜在的风险进行相应的管理后,同济大学附属杨浦医院检验科2015年7—12月尿培养的污染率比2015年1—5月下降了9.3%,且阳性率增加了9.5%。结论识别和管理尿细菌培养检验过程的潜在风险,有利于持续提高尿培养检验结果的质量。
Objective To identify potential risks in urine bacterial culturing and take measures to manage,control,optimize and assess high and medium risks,in order to offer accurate and timely reports. Methods Potential risks which affected the results of urine bacterial culturing in 5 aspects,including people,machine,material,method and process,in pre-examination,intra-examination and post-examination processes. The risks were graded according to severity,probability and detectivity. The unacceptable and measure-required risks should be managed. Results No unacceptable risk was observed in 10 determination procedures. Totally,3 measure-required risks were identified. The 3 measure-required risks were involved 5 key factors,non-standard operation by nurses and contaminative sterile containers in sample collection of pre-examination process,non-standard aseptic operation and failure of timely treatment in intra-examination process and wrong examination result interpretation. After taking relative measures,the contamination rate in urine bacterial culturing decreased by 9.3% from July-December 2015 to January-May 2015,and the positive rate increased by 9.5%. Conclusions Identi？cation and management of potential risks in urine bacterial culturing are bene？cial to improve the quality of urine bacterial culturing continuously.
出处
《检验医学》
CAS
2017年第11期954-957,共4页
Laboratory Medicine
关键词
尿细菌培养
风险识别
风险评价
风险管理
Urine bacterial culturing
Risk identification
Risk assessment
Risk management
