护士在医院POCT—便携式血糖仪质量管理体系中的作用分析(1)
【摘要】 目的：探討护士在医院POCT-便携式血糖仪质量管理体系中的作用，建立有效的床旁检测质量管理体系，确保检测结果的准确性。方法：以本院检验科为技术指导，以临床护士为管理与操作主导，建立室内质控制度，以Westgard多规则质控方法中的13S/22S/R4X为警告与失控规则判断。实行检测者、患者、试剂三码扫描制度确保检测结果可追溯。定期与实验室大型生化仪结果比对，以偏差±20%为界，评价检测结果准确度与精密度。结果：质量管理体系改进前86台POCT血糖仪，35台出现结果不允许的偏差，结果比对合格率为59.3%(51/86)。质量管理体系改进后77台POCT血糖仪，仅2台出现不允许的偏差，比对合格率97.4%(75/77)。质量管理体系改进前后POCT血糖仪与大型生化仪比对结果比较，差异有统计学意义(字2=33.609，P=0.008)。质量管理改进前后便携式血糖仪精密度结果比较，差异无统计学意义(字2=2.736，P=0.098)。结论：虽然目前三级甲等医院评审中POCT管理的条款落在医院检验科，但临床护士是实际操作者与质控管理者，只有提高护士对POCT质量控制的方式方法的认知程度，才能有效提高医院POCT管理质量水平。
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【关键词】 护士； 即时检验； 质量控制； 便携式血糖仪
【Abstract】 Objective：To explore the role of nurses in POCT-portable glucometer quality management system in hospital，to establish an effective quality management system for bedside detection to ensure the accuracy of test results.Method：The laboratory department of our hospital was used as the technical guide，the clinical nurses as the management and operation guide，the indoor quality control system was established，and the 13S/22S/R4X in the multi-rule quality control method of Westgard was taken as the warning and judgment of uncontrolled rule.Three code scanning system of testers，patients and reagents was performed to ensure the traceability of the test results.The accuracy and precision of the test results were evaluated by comparing the results with the laboratory biochemistry instrument regularly，with the deviation ±20% as the limit.Result：Before the improvement of the quality management system，among 86 POCT-portable glucometers，35 had the deviation that the results were not allowed，the qualified rate of the results was 59.3%(51/86).After the improvement of the quality management system，among 77 portable glucometers，only 2 of which were not allowed deviation，the qualified rate of 97.4%(75/77).Before and after the improvement of the quality management system，the comparison results between the portable glucometer and the large biochemical instrument were statistically significant (字2=33.609，P=0.008).Before and after the improvement of quality management，there was no significant difference in the precision of the portable glucometer (字2=2.736，P=0.098). Conclusion：Although the terms of POCT management is in the clinical laboratory in the evaluation of Third Class A Level Hospital，the clinical nurses are the actual operators and quality control managers.Only by improving the nurses’ cognition of POCT quality control methods can effectively improve the POCT management quality level in hospital., 百拇医药(陆惠慧 王欢 周鹤 杨少娣)
, http://www.100md.com
【关键词】 护士； 即时检验； 质量控制； 便携式血糖仪
【Abstract】 Objective：To explore the role of nurses in POCT-portable glucometer quality management system in hospital，to establish an effective quality management system for bedside detection to ensure the accuracy of test results.Method：The laboratory department of our hospital was used as the technical guide，the clinical nurses as the management and operation guide，the indoor quality control system was established，and the 13S/22S/R4X in the multi-rule quality control method of Westgard was taken as the warning and judgment of uncontrolled rule.Three code scanning system of testers，patients and reagents was performed to ensure the traceability of the test results.The accuracy and precision of the test results were evaluated by comparing the results with the laboratory biochemistry instrument regularly，with the deviation ±20% as the limit.Result：Before the improvement of the quality management system，among 86 POCT-portable glucometers，35 had the deviation that the results were not allowed，the qualified rate of the results was 59.3%(51/86).After the improvement of the quality management system，among 77 portable glucometers，only 2 of which were not allowed deviation，the qualified rate of 97.4%(75/77).Before and after the improvement of the quality management system，the comparison results between the portable glucometer and the large biochemical instrument were statistically significant (字2=33.609，P=0.008).Before and after the improvement of quality management，there was no significant difference in the precision of the portable glucometer (字2=2.736，P=0.098). Conclusion：Although the terms of POCT management is in the clinical laboratory in the evaluation of Third Class A Level Hospital，the clinical nurses are the actual operators and quality control managers.Only by improving the nurses’ cognition of POCT quality control methods can effectively improve the POCT management quality level in hospital., 百拇医药(陆惠慧 王欢 周鹤 杨少娣)