頁籤選單縮合
題 名 | 運用品管圈手法降低急診病人部份凝血活酶時間(APTT)假性偏低之比率=Reduce the False Rate of Short Activated Partial Thromboplastin Times (APTT) in an Emergency Department through the Quality Control Circle Activity |
---|---|
作 者 | 李景耀; 楊惠芬; 葉依綾; 劉玉香; 林素美; 蘇姵瑄; 鄭瑞楠; 施勇綸; 陳東榮; | 書刊名 | 臺灣醫學 |
卷 期 | 20:6 2016.11[民105.11] |
頁 次 | 頁625-633 |
分類號 | 419.2 |
關鍵詞 | 品管圈; APTT; Quality control circle activity; |
語 文 | 中文(Chinese) |
中文摘要 | 偏低的APTT( Active partial thromboplastin time, 部份凝血活酶時間)在傳統上被認為是有問題的抽血技術所造成的假性數臄。然而,近年來有證據顯示偏低的APTT反而是反映了人體內為容易凝血的狀態,可能與增加栓塞機率和不良的心血管事件有關。過去文獻指出一般血凝實驗室APTT偏低的比率約為6%-9%,本研究統計個案醫院2014年1月至4月門診、病房和急診室APTT偏低的比例數據,分別為7.8%、8.3%和22.4%,經過探討急診室比率較高的原因是因為抽血流程問題造成,並非是因為容易凝血狀態之病人較多。透過文獻查證以及跨部門團隊合作運用品管圈手法制訂改善策略,採取措施包括:使用真空抽血設備、將APTT藍頭抽血管直立擺放、製作提醒小卡提示採血管要上下混合、制定抽血標準作業流程和在職教育訓練。最後,急診室APTT偏低比率有明顯的改善,由原本改善前的24.3%下降至15.9%。 |
英文摘要 | Short activated partial thromboplastin times (APTTs) are generally considered to be a surrogate marker of inappropriate blood collections. However, recent evidence suggests that short APTT may reflect a hypercoagulable state, potentially associated with an increased thrombotic risk and adverse cardiovascular events. Earlier studies have showed the proportion of short APTT is about 6%-9% in the hemostasis laboratory. We prospectively computed the rate of short APTT in outpatient, inpatient and emergency (ER) from January to April, 2014, and the proportion were 7.8%, 8.3% and 22.4%, respectively. We assumed that higher proportion in ER might be due to the inappropriate blood collections not more patients in a hypercoagulable state. Through a literature review and in accordance with the improvement strategy, the following methods were taken: using vacuum extraction tube systems, putting sodium citrate tube upright, reminding cards for overturning the blood collection tube, creation of standard operating procedures, in-service training. In conclusion, there was a significant reduction in the proportion of short APTT in ER with a reduction from 24.3% to 15.9%. |
本系統中英文摘要資訊取自各篇刊載內容。