放血培训对开普敦初级卫生保健提供者血液样本拒收率及放血知识的影响：一项准实验研究。
The effect of phlebotomy training on blood sample rejection and phlebotomy knowledge of primary health care providers in Cape Town: A quasi-experimental study.
作者信息
Abbas Mumtaz, Mukinda Fidele K, Namane Mosedi
机构信息
Department of Family Medicine and Public Health, University of Cape Town.
出版信息
Afr J Prim Health Care Fam Med. 2017 Apr 13;9(1):e1-e10. doi: 10.4102/phcfm.v9i1.1242.
BACKGROUND
There is an increasing amount of blood sample rejection at primary health care facilities (PHCFs), impacting negatively the staff, facility, patient and laboratory costs.
AIM
The primary objective was to determine the rejection rate and reasons for blood sample rejection at four PHCFs before and after a phlebotomy training programme. The secondary objective was to determine whether phlebotomy training improved knowledge among primary health care providers (HCPs) and to develop a tool for blood sample acceptability.
STUDY SETTING
Two community health centres (CHCs) and two community day centres (CDCs) in Cape Town.
METHODS
A quasi-experimental study design (before and after a phlebotomy training programme).
RESULTS
The sample rejection rate was 0.79% (n = 60) at CHC A, 1.13% (n = 45) at CHC B, 1.64% (n = 38) at CDC C and 1.36% (n = 8) at CDC D pre-training. The rejection rate remained approximately the same post-training (p > 0.05). The same phlebotomy questionnaire was administered pre- and post-training to HCPs. The average score increased from 63% (95% CI 6.97‒17.03) to 96% (95% CI 16.91‒20.09) at CHC A (p = 0.039), 58% (95% CI 9.09‒14.91) to 93% (95% CI 17.64‒18.76) at CHC B (p = 0.006), 60% (95% CI 8.84‒13.13) to 97% (95% CI 16.14‒19.29) at CDC C (p = 0.001) and 63% (95% CI 9.81‒13.33) to 97% (95% CI 18.08‒19.07) at CDC D (p = 0.001).
CONCLUSION
There is no statistically significant improvement in the rejection rate of blood samples (p > 0.05) post-training despite knowledge improving in all HCPs (p < 0.05).
背景
基层医疗保健机构（PHCFs）的血样拒收情况日益增多，对工作人员、机构、患者及实验室成本产生了负面影响。
目的
主要目标是确定在开展静脉穿刺培训项目前后，四家基层医疗保健机构的血样拒收率及血样拒收原因。次要目标是确定静脉穿刺培训是否提高了基层医疗保健提供者（HCPs）的知识水平，并开发一种血样可接受性工具。
研究地点
开普敦的两家社区卫生中心（CHCs）和两家社区日间中心（CDCs）。
方法
采用准实验研究设计（静脉穿刺培训项目前后）。
结果
培训前，A社区卫生中心的样本拒收率为0.79%（n = 60），B社区卫生中心为1.13%（n = 45），C社区日间中心为1.64%（n = 38），D社区日间中心为1.36%（n = 8）。培训后拒收率大致保持不变（p > 0.05）。在培训前后，对基层医疗保健提供者进行了相同的静脉穿刺问卷调查。A社区卫生中心的平均得分从63%（95%可信区间6.97‒17.03）提高到96%（95%可信区间16.91‒20.09）（p = 0.039），B社区卫生中心从58%（95%可信区间9.09‒14.91）提高到93%（95%可信区间17.64‒18.76）（p = 0.006），C社区日间中心从60%（95%可信区间8.84‒13.13）提高到97%（95%可信区间16.14‒19.29）（p = 0.001），D社区日间中心从63%（95%可信区间9.81‒13.33）提高到97%（95%可信区间18.08‒19.07）（p = 0.001）。
结论
尽管所有基层医疗保健提供者的知识水平有所提高（p < 0.05），但培训后血样拒收率没有统计学上的显著改善（p > 0.05）。
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