十堰市血液库存管理现状SWOT分析及建议

目的了解十堰市血液库存管理现状,为提升血液库存管理水平,保障辖区内血液供应提供决策依据。方法采用SWOT分析法对十堰市2014—2017年血液采集、供应和库存管理情况进行分析。结果十堰市血液库存管理的优势(S):无偿献血氛围良好,血源相对充足;全省血液互动调剂,可有效调节库存量。劣势(W):绩效考核模式不利于血液采集计划的调控;供血区域跨度大,送血及时性有待提升;临床不合理用血和不合理库存影响血站的库存管理。机会(O):自体输血和科学用血的管控有利于降低供需矛盾;循证医学的发展为血站参与临床输血管理提供机遇。威胁(T):临床用血和无偿献血的不确定性;血液替代品的研发使用;设备和人员短缺;血液应急预案的响应能力都在不同程度影响血液库存管理。结论采供血机构需充分利用优势,有效规避劣势和风险,建立合理高效的血液库存管理机制,确保临床血液供应需求性和及时性。     

关于进一步落实科学防治精准施策分区分级要求做好疫情期间血液保障工作的通知

正联防联控机制发[2020]31号各省、自治区、直辖市及新疆生产建设兵团应对新型冠状病毒肺炎疫情联防联控机制(领导小组、指挥部):新冠肺炎疫情发生以来,各地高度重视血液安全供应工作,建立血液库存监测预警制度,加强无偿献血宣传动员,启动血液调配机制,血液供应平稳有序,有力保障临床医疗救治。近期,随着正常的医疗服务秩序逐步恢复,临床用血需求大幅增加,部分地区出现     

基于RFID技术的临床用血物联网管理方案应用

目的探讨与评价物联网血液管理解决方案在医疗机构临床用血管理中的应用效果。方法基于无线射频识别技术(RFID),通过开发智能血液冰箱、物联网血液转运箱、自动化血库系统、智慧血液管理软件等构建物联网血液智慧管理平台(方案),将血液贮存与管理软硬件系统有机结合,将分布式血液贮存储设备前移至临床用血科室,解决临床医师的用血顾虑。结果物联网技术、RFID与制冷技术的深度融合,构建起基于RFID的物联网血液管理解决方案,其将血液贮存、使用与质控管理集于一身,实现了对临床用血的全流程监管和信息追溯。血库前移至临床用血科室与电子交叉配血,精简和优化了临床用血流程,患者输血等待时间(min)由40±10缩短至<2;全程冷链物流确保出库血液的贮存质量,临床用血科室得以退回未输(完)的血液,输血科可以再发放临床或用与其他医院调剂。结论基于RFID血液管理物联网解决方案实现了临床用血智能化管理和血液(袋)信息追溯;医院血库前移至用血科室,提高了临床输血效率、避免了血源浪费,提高了输血安全性。     

医院血液库存量及库存预警机制的制定与应用

目的通过合理设定我院血液库存量,建立临床切实可行的库存预警机制,从而实现临床血源信息预警,规范调配血液,指导合理用血。方法对本院2011年6月-2013年6月临床每日各型用血量、月用血量、离散度、用血频次等数据进行描述性统计学分析,设定比较科学合理的血液库存量,并在此基础上分析2012年5月-2013年6月用血目的数据,建立3级库存预警机制并制定每级对应措施。结果通过统计学分析发现,每日用血情况具有不确定性,是偏态分布数据,按照百分位数来设定库存量更为科学。综合考虑各型每日用血量,每日不同用血量频次、最大及最小用血量、血液输注期效性等因素,制定出适合我院的基础库存量A∶36 U,B∶48 U,O∶42 U,AB∶12 U;分析不同用血目的,制定3级预警机制,各级预警线下限为:1级预警线:A∶12 U、B∶16 U、O∶18 U、AB∶6 U;2级预警线:A∶18 U、B∶22 U、O∶22 U、AB∶8 U,3级预警线:A∶26 U、B∶30 U、O∶32 U、AB∶10 U。结论医院输血科要科学制定符合本院实际的血液库存,以最大限度地合理有效使用血液;血液库存预警机制的实施,有效提高了临床在血源供应紧张时的应对能力,缓解了用血供需矛盾,降低了由此引发医患矛盾的可能性。     

重大突发公共卫生事件下保障临床输血安全的思考与展望

受新型冠状病毒疫情影响，截至 2020 年 1 月底，全国 31 个省、市、自治区相继启动重大突发公共卫生事件一级响应。紧急防控状态下，全国各地停工停产，封城封路，人民居家隔离，无偿献血工作被迫取消，血液库存管理受到严峻考验。若疫情持续发展或突发未知公共卫生事件，各采供血机构及各级医院输血科该如何应对，以安全有效地保障临床用血，迫在眉睫。该文就在重大突发公共卫生事件下，为确保血液库存充足及采供血安全方面可采取的应对措施作以总结，以期为临床采供血及临床安全用血环节提供新思路。     

浅析输血管理信息系统在加强临床安全用血中的作用

随着输血事业的不断深入和发展,用血安全已引起社会的广泛关注,输血管理信息系统的作用日益凸显。本文从用血申请管理、输血实验室管理、血液发放管理和血液库存管理四方面浅析输血管理信息系统在加强临床安全用血中的作用。     

临床用血闭环式管理模式的建立与运行实效

目的建立医院可以对临床用血全过程实时监控的闭环式管理模式。方法由医院临床用血管理委员会(临床用血管委会)整合医院信息系统、电子病历系统、实验室信息系统、移动护理系统、手术麻醉系统、输血管理系统以及临床用血评估系统,输血科应用信息化手段管理输血申请与审核、库存预警、血清学相容性检测、血液发放、临床输血、自体输血管理、输血不良事件上报、申请用血评估以及输血后评价各个步骤,使全院的临床用血全过程处于临床用血管委会和输血科实时监控的闭环管理中。结果临床用血过程闭环管理实施前后3年的平均数据显示住院患者人数增加15.11%的情况下,临床用血总量减少4.44%,人均用血量减少14.64%;手术台数增加14.09%的情况下,手术用红细胞减少18.45%,手术科室自体血输血比例增加9.02%;临床用血过程闭环管理规范医院临床科室的用血行为,规范了输血科的用血管理,减少了手工录入环节导致的人为误差,保障了临床用血信息的准确性,提高了临床用血的安全性、可控性。结论临床用血闭环式管理有效提高了医院临床用血安全性、可控性会和适用性。     

新型冠状病毒肺炎疫情期间输血科整体工作开展策略

目的 通过对新型冠状病毒肺炎(COVID-19)疫情期间输血科制订的输血方案的分析,探讨COV-ID-19疫情期间输血科工作开展的整体策略,为疫情再次发生时临床用血提供参考.方法 选取河南科技大学第一附属医院输血科2020年1-3月临床申请用血的1406例患者为研究对象,对其用血量、输血申请流程、成分血发放流程及血液标本的处理流程进行探讨研究.结果 2020年1-3月悬浮红细胞总用量为7730 U,较去年同期降低,且以血液科用血为主,手术及急诊科用血明显减少.根据各级防控文件及指南制订了输血相关防控措施.结论 针对疫情特殊时期采取有效的防控措施,可保障患者及医护人员的安全.     

泉州地区二级以上综合医院输血科现状分析

目的对泉州地区16家二级以上综合医院进行检查,提出整改措施,加强临床合理用血的管理,促进医院输血科的建设。方法本次临床用血督导检查,主要从医院输血组织管理、输血科建设及临床合理用血管理等方面进行设计,具体包括机构设置和管理制度、输血规范和科学合理用血、血液贮存发放和输血质量管理等方面。结果机构设置和管理制度、科学合理用血、血液贮存发放和输血质量管理,三者的平均合格率分别为86.6%、68.1%、89.2%。结论卫生行政部门和医疗机构应进一步重视医院输血科,加强科室建设;其次医疗机构应加大宣传、培训力度,积极开展自身输血,强化临床医护人员的输血安全意识,合理控制用血,节约血液资源。     

建立医疗机构血液库存动态预警机制的探讨

《中华人民共和国献血法》颁布至今,随着我国从计划经济向市场经济转型．临床用血紧张情况时有发生。特别是近年来我国不少地区的血液供应紧张日益呈现常态．血液库存红色预警频繁出现。同时随着医疗水平的发展．临床用血数量的逐年增加．输血安全成为日益关注的问题吲．而现在的血源紧缺成了输血安全最大的问题。《医疗机构临床用血管理办法》第十三条规定,     

Management of blood supply and demand during the COVID-19 pandemic in King Abdullah Hospital,Bisha, Saudi Arabia

BackgroundMaintaining blood supply is essential since blood transfusions are lifesaving in many conditions. The 2003 infectious outbreak of SARS-CoV had a negative impact on blood supply. This study aimed to measure donor attendance and blood demand in order to help find efficient ways of managing blood supply and demand during the COVID-19 pandemic and similar public emergencies in the future.Materials and methodsData from donor attendance, mobile blood drives and blood inventory records were retrospectively obtained for the period between 1 September 2019 and 1 May 2020 to assess the impact of COVID-19 on donor attendance and the management of blood supply and demand in King Abdullah Hospital, Bisha, Saudi Arabia. Data were analysed using SPSSStatistics, version 25.0. Categorical variables were described using frequencies and percentages.ResultsAfter imported cases of COVID-19 were reported in Saudi Arabia, donor attendance and blood supply at blood bank-based collections showed a drop of 39.5%. On the other hand, blood demand during the same period was reduced by 21.7%.ConclusionsThe COVID-19 pandemic had a negative impact on donor attendance and blood supply and adversely affected blood transfusion services. Guidelines that prioritize blood transfusion should prepare at the beginning of emergencies similar to this pandemic. Close monitoring of blood needs and blood supply and appropriate response is essential for avoiding sudden blood shortage. An evidence-based emergency blood management plan and flexible regulatory policy should be ready to deal with any disaster and to respond quickly in the case of blood shortage.     

新型冠状病毒肺炎疫情期间综合医院护理应急人员储备库的建立与管理

目的 总结新型冠状病毒肺炎疫情期间,综合医院基于信息网络技术建立与管理护理应急人员储备库的经验。 方法 调整组织管理架构;基于组建原则及流程建立护理应急人员储备库;基于医院信息平台实施应急人员基本信息的维护、新冠肺炎知识及相关技能的培训、实施多方位的心理支持及人文关怀,做好人员的应急储备工作。 结果 截止至2020年2月15日,共有553名护理人员入库,其中备岗260人,293人参与一线疫情防控工作。 结论 基于信息网络技术建立护理应急人员储备库,确保了疫情时期高效的人力调度及人员的动态管理,为后续灾害救援工作积累了经验。     

Blood inventory management: hospital best practice

Blood is a perishable product, and hence good management of inventories is crucial. Blood inventory management is a trade-off between shortage and wastage. The challenge is to keep enough stock to ensure a 100% supply of blood while keeping time expiry losses at a minimum. This article focuses on inventory management of red blood cells in hospital transfusion laboratories to derive principles of best practice and makes recommendations that will ensure losses due to time expiry are kept to a minimum. The literature was reviewed to identify available models for perishable inventory management. Historical data from the UK blood supply chain was analyzed to identify hospitals with good inventory management practice and low wastage levels. Transfusion laboratory managers in the selected hospitals were interviewed in 7 case studies with the aim of identifying drivers for low wastage and good inventory management practice. The findings from the case studies were compared with the literature. The extant literature asserts that the drivers for good inventory performance are the use of complex inventory models and algorithms. This study has found this not to be the case. Instead, good performance is driven by the quality of transfusion laboratory staff, who must be skilled, regularly trained, and experienced. Electronic crossmatching, transparency of the inventory, and simple management procedures also facilitate good performance.     

COVID-19 related callback in blood donors; Outcomes in blood donors and patients

Call back as a procedure to report post donation symptoms or illness by donors has been established since 2009 in Iranian Blood Transfusion Organization (IBTO). During the first phase of COVID-19 outbreak, all blood donors were requested to report any respiratory infection symptoms after donation. The study investigated the callback data of COVID-19 in Tehran Blood Center during the first 3 months of the outbreak in Iran. The purpose of this study was to estimate the frequency of post donation COVID-19 related call back reports and determine its implications for blood donors and patients.A telephone interview was conducted with donors who had reported COVID-19 symptoms. Some questions were asked to evaluate donor′s health at the time of blood donation. The donors categorized into three groups: laboratory-confirmed, suspected, and COVID-19 irrelevant based on their answers. In cases that the blood component obtained from a laboratory-confirmed donor had been released, the hospital was notified and asked to follow up the recipient for COVID-19.The results showed 30 donors (0.08 %) had callback related to COVID-19 and 76.63 % of the obtained component was disposed. The results also showed that only one donor had a laboratory-confirmed result with the RBC unit processed from her whole blood released for transfusion. The RBC unit recipient did not show any signs or symptoms of infection during a 46-day follow-up.Concluded that callback system was effective to remove most of the components obtained from the donors who reported to be COVID-19 suspected or confirmed. Moreover, the result did not support virus transmission through blood transfusion.     

基于移动智能办公平台构建康复医院重大疫情防控护理信息管理模式

在新型冠状病毒肺炎(简称新冠肺炎)疫情期间,我院基于智能移动办公系统平台构建重大疫情防控护理信息化管理新模式,实现重大疫情防控时护理人力资源管理、防控及心理知识培训、应急物资管理、质量管理、相关信息筛查的线上管理,构筑了抗击疫情的"堡垒",保障了医疗救治工作安全、有序、高效的开展,实现了医护工作者与患者零感染的目标。因此,本文对基于智能移动办公系统平台构建康复医院重大疫情防控的护理信息化管理新模式进行介绍,旨在为康复类医院重大疫情防控护理管理提供参考。     

Promoting access to COVID-19 convalescent plasma in low- and middle-income countries

Low- and middle-income countries (LMICs) remain neglected in the Coronavirus 19 (COVID-19) pandemic. COVID-19 convalescent plasma (CCP) (i.e. plasma collected from individuals after their recovery from COVID-19) has emerged as a leading medical treatment for COVID-19. Studies to date support the safety—and increasingly the efficacy—of CCP to treat COVID-19. This has motivated large-scale procurement and transfusion of CCP, notably in the United States (US), where inventories of CCP have been attained, and government-supported stockpiling of CCP is underway. CCP is a therapy that could be implemented in LMICs. However, systemic and transfusion-specific challenges (e.g. capacity for donor mobilization and collections) impede local procurement of this resource in sufficient volumes to meet clinical demand. This raises the question as to whether there are strategies to facilitate sharing of CCP with LMICs and/or bolstering local capacity for collection to contend with the health crisis. While compelling, there are cost-related, logistical and regulatory barriers to both approaches. For one, there is complexity in diverting national interest (e.g. in the US) away from an epidemic that displays few signs of abating. There are also concerns regarding equitable distribution of CCP in LMICs and how that might be overcome. Further, the barriers to blood donation in general apply to collection of CCP; these obstacles are longstanding, accounting for the inability of many LMICs to meet their blood transfusion needs. Nonetheless, CCP affords dual opportunity for humanitarian outreach while tackling a broader challenge of blood transfusion safety and availability.     

Patient Blood Management: A Patient-Orientated Approach to Blood Replacement with the Goal of Reducing Anemia,Blood Loss and the Need for Blood Transfusion in Elective Surgery

Patient Blood Management (PBM) describes an evidence-based, multidisciplinary therapeutic approach. Its focus is on the treatment of the individual patient and as such comprises transfusion therapy and pharmacotherapy. Furthermore, the applicability of PBM is not limited to the perioperative setting but is applicable also to other therapeutic measures and disciplines where significant blood loss is known to occur and where transfusion of blood products is part of the established treatment. PBM is fundamentally based on 3 pillars: (1) optimization of the (preoperative) erythrocyte volume, (2) reduction of diagnostic, therapeutic, or intraoperative blood loss, and (3) increasing individual tolerance towards anemia and accurate blood transfusion triggers. PBM primarily identifies patients at risk of transfusion and provides a management plan aimed at reducing or eliminating the risk of anemia and the need for allogeneic transfusion, thus reducing the inherent risks, inventory pressures, and the escalating costs associated with transfusion.     

新型冠状病毒肺炎防控期间综合医院员工的健康防控管理探讨

目的探讨新型冠状病毒肺炎防控期间综合医院员工健康防控管理的措施。 方法利用质量控制管理工具中的分层法，通过涵盖全员覆盖培训，依照疫情特点精细分组，梯队式健康上报流程的“3M工作方案”，实现全院员工的整体防控和管理。 结果2020年1月29日至6月6日，全院4463名员工“零感染”。 结论作为防疫“第一哨岗”的综合医院，科学精准的管理方法、全面覆盖的教学培训，是降低院内感染、保护医患安全的关键。