Murphy M F, Stearn B E, Dzik W H
National Blood Service, John Radcliffe Hospital, Headington, Oxford OX3 9BQ, UK.
Transfus Med. 2004 Apr;14(2):113-21. doi: 10.1111/j.0958-7578.2004.0488.x.
Collection of the patient sample for pretransfusion testing begins a complex chain of events in the transfusion process. Hospitals in England and North Wales were surveyed to compare local policies against recommendations of the British Committee for Standards in Haematology (BCSH). Hospitals also measured the frequency of rejected and miscollected samples [designated as wrong blood in tube (WBIT)]. 185 of 360 (51.4%) hospitals returned questionnaires and 182 of 185 (98%) hospitals reported that a policy for sample collection existed. Apart from frequent omission of the gender of the patient, there was 96% compliance with all mandatory identifiers of the BCSH guidelines. Practice allowing additions or changes to labelling on sample tubes and request forms varied. 3.2% (14 114/445 726) of samples submitted were rejected for various reasons, the most frequent being incomplete or missing information (49.5% of the total rejected samples). The corrected mean frequency for WBIT in the 27 hospitals with one or more observed WBIT was 1 in 1501 samples (95% CI: < or =1129.09 to < or =1872.91), and the median corrected frequency for WBIT was 1 in 1303 samples. This study has identified great variation in the policy and practice for sample collection for pretransfusion testing. Regular tracking of the rates of sample rejection and WBIT could be used to identify poor performance in individual hospitals requiring investigation and action.
采集患者样本用于输血前检测开启了输血过程中一系列复杂的事件。对英格兰和北威尔士的医院进行了调查,以比较当地政策与英国血液学标准委员会(BCSH)的建议。医院还统计了被拒收和采集错误的样本(定义为管内血型错误,WBIT)的发生率。360家医院中有185家(51.4%)回复了问卷,185家中的182家(98%)报告存在样本采集政策。除了经常遗漏患者性别外,BCSH指南所有强制标识符的符合率为96%。允许在样本管和申请表上添加或更改标签的做法各不相同。提交的样本中有3.2%(14114/445726)因各种原因被拒收,最常见的原因是信息不完整或缺失(占被拒收样本总数的49.5%)。在观察到有一个或多个WBIT的27家医院中,WBIT的校正平均发生率为每1501个样本中有1例(95%CI:≤1129.09至≤1872.91),WBIT的校正频率中位数为每1303个样本中有1例。本研究发现输血前检测样本采集的政策和实践存在很大差异。定期跟踪样本拒收率和WBIT发生率可用于识别需要调查和采取行动的个别医院的不佳表现。