以反馈干预为目的、由输血医师主导的临床用血评估评价方法的建立及应用

doi:10.3969/j.issn.1671-2587.2017.03.003

临床输血与检验 ›› 2017, Vol. 19 ›› Issue (3): 217-221.DOI: 10.3969/j.issn.1671-2587.2017.03.003

以反馈干预为目的、由输血医师主导的临床用血评估评价方法的建立及应用

聂志扬, 胡俊华, 李淑萍, 宫济武

100730 北京医院输血科,国家老年医学中心（聂志扬,胡俊华,宫济武）;
北京同仁医院输血科（李淑萍）

收稿日期:2017-01-17 出版日期:2017-06-20 发布日期:2017-06-23
通讯作者: 李淑萍女,副主任技师,学士,（E-mail） lishp0503@163.com。宫济武,男,主任技师,学士,（E-mail）13910066259@139.com。
作者简介:聂志扬（1985-）,女,安徽合肥人,主治医师,硕士,主要从事临床输血工作,（E-mail）niezhiyang4286@bjhmoh.cn。

Establishment and Application of Prospective Auditing and Post-transfusion Evaluation System Aiming to Feedback Intervention by Transfusion Physician

Nie zhi-yang, HU Jun-hua, LI Shu-ping, et al

Department of Blood Transfusion,Beijing Hospital,Beijing 100730

Received:2017-01-17 Online:2017-06-20 Published:2017-06-23

摘要/Abstract

摘要： 目的探讨建立临床用血评估评价的方法和意义,建立高效的临床用血评估评价体系,反馈干预临床,提高用血质量。方法制定临床用血评估评价流程,在细化输血管理信息系统对相关数据统计分析的基础上,加强输血医师对医疗过程记录的检查。结果内科治疗输血前评估由输血医师结合实验室指标和病历记录进行。围手术期用血风险评估需构建单病种术中及术后用血影响因素评分系统,以腰椎管狭窄症为例,评分4分以上患者的围手术期用血比例>50%。这些评估方法显著降低了申请量及发血量。输血后评价首先由输血管理信息系统按单病种或科室自动进行,对不合理用血病例由输血医师依据病历记录进行人工评价。结论以信息系统数据和医疗记录为基础,由输血医师进行个体化临床用血评估评价才能更好的反馈干预临床工作,符合循证医学和精准医学的要求。

关键词: 反馈干预, 输血前评估, 输血后评价

Abstract: Objective To explore the methodology and significance of prospective auditing and evaluation system for blood transfusion and establish an effective system,which can feedback intervene to promote quality of clinical transfusion. Methods First we develop the process of blood transfusion prospective auditing and evaluation. It demands for enhanced medical record and better statistics for optimal auditing and evaluation by transfusion physician. Results Transfusion in Medical treatment should be auditd with laboratory indicators and medical records. Perioperative transfusion risk can be assessed by a scoring system for each disease. For example,the patients with lumbar spinal stenosis scored over 4 points have a ratio of >50% for perioperative transfusion. These Methods could obviously reduce the volume of blood requested and used. Post-transfusion evaluation should be automatically evaluated by transfusion management information system,and then the inappropriate case would be re-evaluated by transfusion physician according to the medical records. Conclusion Clinical data and records are useful tools for prospective auditing and evaluation. Individual prospective auditing and evaluation by transfusion physician can meet the requirements of evidence-based medicine and precision medicine.

Key words: Feedback intervention, Pro-transfusion evalution, Post-transfusion evaluation

中图分类号:

R457.1

聂志扬, 胡俊华, 李淑萍, 宫济武. 以反馈干预为目的、由输血医师主导的临床用血评估评价方法的建立及应用[J]. 临床输血与检验, 2017, 19(3): 217-221.

Nie zhi-yang, HU Jun-hua, LI Shu-ping, et al. Establishment and Application of Prospective Auditing and Post-transfusion Evaluation System Aiming to Feedback Intervention by Transfusion Physician[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2017, 19(3): 217-221.

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以反馈干预为目的、由输血医师主导的临床用血评估评价方法的建立及应用

Establishment and Application of Prospective Auditing and Post-transfusion Evaluation System Aiming to Feedback Intervention by Transfusion Physician

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