河北省供血系统现状调研分析
|
摘要
目的通过对河北省12家血站供血科基本情况调研,以了解河北省血站供血系统现状,为今后供血科建设提供参考。方法以调查问卷方式向河北省12家血站发放,问卷涉及内容包括2014—2016年度红细胞血小板血浆及冷沉淀的发放量、日均库存量、合格品库最大库存容量,供血科岗位职责、岗位人员数量和员工职称情况,供血科场地面积,计算机管理情况和直供血医院数量及与用血医院联网情况等,各类血液制剂均按U数计算,反映工作人员工作量大小以人均日工作强度表示,反映工作场地大小以面积强度表示,反映库存量多少以囤积天数表示,并做统计学分析,当P<0.05时认为有统计学意义。结果 2014—2016年全省血站发放量除红细胞2015年低于上年度外,血小板、血浆和冷沉淀均呈逐年增加的趋势;红细胞库存量逐年减少、血小板和血浆逐年增加;本中心红细胞和血小板3年日均囤积天数均大于全省平均值并均呈逐年增加趋势;全省血站血浆储存空间严重不足;供血岗或管理岗人员职称为高、中、初级,非卫技人员和工人基本分布在包装岗位;全省其他血站供血岗位人均工作强度及供血科工作面积强度与本中心比较有显著性统计学差异(P<0.05),本中心工作人员劳动强度在全省血站居首位;全省12家血站均与用血医院联网,有5家血站所供血医院实现网上订血、网上入库、网上配血和网上出库四项规范性基本操作,有4家血站所供血医院只执行网上订血、网上入库、和网上出库三项操作,另有3家血站所供血医院只执行网上入库和网上出库两项操作;有4家血站存在工作场地不足、人员设备不足、场地不足、人员审核疏忽等因素,曾出现甚至隐藏着血液出库漏扫信息的隐患。结论各血站血浆积压问题严重,呼吁从国家层面给予政策支持。各血站特别是年供血量较大的血站,在供血岗位人员配置方面,应该考虑到人均工作强度,将工作强度作为定值再根据年发血量来配备人数。解决血液成分储存空间不足问题,一方面建造扩大冷库,另一方面减少血液的囤积天数,既扩大了储存空间使血液出入库保持有序循环,又能有效应对突发大量采血事件,还能提升发往临床血液的新鲜度。供血岗位人员不应该只是简单的发血,而要达到一专多能,加强对输血专业知识的培训,及时有效为临床科学合理用血提供咨询指导服务。无论哪级血站,从系统管理差错和有效保证血液安全考虑,在供血科安装RFID系统是有效防范措施。
Objective To understand the status of the department of blood supply in Hebei province blood banks through investigating the basic situation of the department of blood supply in 12 blood centers of Hebei province in order to provide reference for the construction of the department of blood supply for the future. Methods Questionnaires were sent out to the 12 blood centers in Hebei province in the manner of questionnaire survey. The contents of questionnaires included the amount of annual red blood cell(RBC) platelet-rich plasma and cryoprecipitate sent out,inventory level per day,the maximum amount of storage capacity for the qualified product inventory,responsibility of the department of blood supply,the number of staffs in the position and the professional qualifications,size of the working place for the department of blood supply,situation of computer management,the number of hospitals to which the blood was directly delivered and situation of networking with hospitals from 2014 to 2016. Each blood product was calculated based on units,daily working intensity per person was used to reflect the workload of staffs,the size intensity was used to reflect the size of the working place,the hoarding days was used to reflect the quantity of inventory. The data were analyzed statistically,and P values less than 0. 05 was consider to be statistically significant difference. Results From 2014 to 2016,only the amount of RBCs sent out was lower in2015 than in 2014 in the blood centers of Hebei province,the amount of platelets,plasma and cryoprecipitate sent out showed an increasing trend. The inventory level of RBCs decreased year by year,while the inventory level of platelets and plasma increased year by year. The hoarding days of RBCs and platelets per day in 3 years in Hebei Province Blood Center were more than the mean value of the province and showed an increasing trend year by year. There were serious deficiencies in the storage space for plasma in the province. The professional qualifications of the staffs in the blood supply position or in the management position were senior,intermediate and junior titles. The staffs who were not health technical persons and workers were mainly in the packaging position. There were statistically significant differences in the working intensity per person in the blood supply position and the intensity of size of the working place for the department of blood supply between the other blood centers in the province and Hebei Province Blood Center(P < 0. 05),and the working intensity of the staffs in Hebei Province Blood Center topped the list among the blood centers in the province. There was networking between the 12 blood centers in the province and hospitals requiring blood. The four standardized basic procedures online blood ordering,online storage,online blood matching and online delivery were achieved in hospitals requiring blood supplied by 5 blood centers. Three standardized basic procedures online blood ordering,online storage and online delivery were achieved in hospitals requiring blood supplied by 4 blood centers. Two standardized basic procedures online storage and online delivery were achieved in hospitals requiring blood supplied by 3 blood centers. There were factors such as lack of workplace,lack of persons and equipments,lack of work place,negligence of personnel checking in 4 blood centers,and missing of information scanning during delivery once happened and was still hidden. Conclusion Plasma backlog problems are serious in each blood center,and these problems appeal to the nation who can provides support in aspect of the policy. Each blood center especially the centers in which the annual amount of blood sent out is larger should consider the working intensity per person with respect to the distribution of staffs in the blood supply position,the working intensity is considered a constant value,and the number of staffs is then determined according to the volume of blood sent out. In order to solve the problem the insufficient storage space for blood products,on the one hand,the size of the refrigerator could be enlarged,on the other hand,the hoarding days of the blood could be reduced. Not only the storage space is enlarged,the orderly circulation is kept for the blood supplied and sent out,but also the blood centers can deal with a large volume of blood collecting emergencies,and the freshness of blood sent out to the clinic is also raised. The staffs in the blood supply position should expert in one thing and good at many,strengthen the professional knowledge training for blood transfusion and provide advice and guidance service for scientific rational clinical use of blood in addition to the simple blood delivering job. Installing RFID system in the department of blood supply is an effective defensive measure from the point of system management mistakes and effectively guaranteeing the safety of blood in all the blood centers regardless of the grade.
Objective To understand the status of the department of blood supply in Hebei province blood banks through investigating the basic situation of the department of blood supply in 12 blood centers of Hebei province in order to provide reference for the construction of the department of blood supply for the future. Methods Questionnaires were sent out to the 12 blood centers in Hebei province in the manner of questionnaire survey. The contents of questionnaires included the amount of annual red blood cell(RBC) platelet-rich plasma and cryoprecipitate sent out,inventory level per day,the maximum amount of storage capacity for the qualified product inventory,responsibility of the department of blood supply,the number of staffs in the position and the professional qualifications,size of the working place for the department of blood supply,situation of computer management,the number of hospitals to which the blood was directly delivered and situation of networking with hospitals from 2014 to 2016. Each blood product was calculated based on units,daily working intensity per person was used to reflect the workload of staffs,the size intensity was used to reflect the size of the working place,the hoarding days was used to reflect the quantity of inventory. The data were analyzed statistically,and P values less than 0. 05 was consider to be statistically significant difference. Results From 2014 to 2016,only the amount of RBCs sent out was lower in2015 than in 2014 in the blood centers of Hebei province,the amount of platelets,plasma and cryoprecipitate sent out showed an increasing trend. The inventory level of RBCs decreased year by year,while the inventory level of platelets and plasma increased year by year. The hoarding days of RBCs and platelets per day in 3 years in Hebei Province Blood Center were more than the mean value of the province and showed an increasing trend year by year. There were serious deficiencies in the storage space for plasma in the province. The professional qualifications of the staffs in the blood supply position or in the management position were senior,intermediate and junior titles. The staffs who were not health technical persons and workers were mainly in the packaging position. There were statistically significant differences in the working intensity per person in the blood supply position and the intensity of size of the working place for the department of blood supply between the other blood centers in the province and Hebei Province Blood Center(P < 0. 05),and the working intensity of the staffs in Hebei Province Blood Center topped the list among the blood centers in the province. There was networking between the 12 blood centers in the province and hospitals requiring blood. The four standardized basic procedures online blood ordering,online storage,online blood matching and online delivery were achieved in hospitals requiring blood supplied by 5 blood centers. Three standardized basic procedures online blood ordering,online storage and online delivery were achieved in hospitals requiring blood supplied by 4 blood centers. Two standardized basic procedures online storage and online delivery were achieved in hospitals requiring blood supplied by 3 blood centers. There were factors such as lack of workplace,lack of persons and equipments,lack of work place,negligence of personnel checking in 4 blood centers,and missing of information scanning during delivery once happened and was still hidden. Conclusion Plasma backlog problems are serious in each blood center,and these problems appeal to the nation who can provides support in aspect of the policy. Each blood center especially the centers in which the annual amount of blood sent out is larger should consider the working intensity per person with respect to the distribution of staffs in the blood supply position,the working intensity is considered a constant value,and the number of staffs is then determined according to the volume of blood sent out. In order to solve the problem the insufficient storage space for blood products,on the one hand,the size of the refrigerator could be enlarged,on the other hand,the hoarding days of the blood could be reduced. Not only the storage space is enlarged,the orderly circulation is kept for the blood supplied and sent out,but also the blood centers can deal with a large volume of blood collecting emergencies,and the freshness of blood sent out to the clinic is also raised. The staffs in the blood supply position should expert in one thing and good at many,strengthen the professional knowledge training for blood transfusion and provide advice and guidance service for scientific rational clinical use of blood in addition to the simple blood delivering job. Installing RFID system in the department of blood supply is an effective defensive measure from the point of system management mistakes and effectively guaranteeing the safety of blood in all the blood centers regardless of the grade.
引文
[1]献血场所配置要求.WS/T 401-2012
[2]赵凤绵,刘晓彦,孟趁乔,等.河北省血液中心库存去白悬浮红细胞储存期现状分析.中国输血杂志,2017,30(2);161-163
[3]血站管理办法.卫医发[2006]44号.
[4]血液运输要求.WS/T 400-2012
[5]血站质量管理规范.卫医发[2006]167号
[2]赵凤绵,刘晓彦,孟趁乔,等.河北省血液中心库存去白悬浮红细胞储存期现状分析.中国输血杂志,2017,30(2);161-163
[3]血站管理办法.卫医发[2006]44号.
[4]血液运输要求.WS/T 400-2012
[5]血站质量管理规范.卫医发[2006]167号