基于Donabedian三维理论的上呼吸道核酸检测标本采集的质量管理实践

目的:分析Donabedian三维理论指导下,新冠肺炎核酸检测标本采集的质量管理实践效果。方法:分析影响上呼吸道核酸检测标本采集质量的影响因素,根据Donabedian三维理论制定标本采集管理策略,应用于2020年1月23日至2月17日我院新冠肺炎疑似患者及相关人群,共采集上呼吸道核酸标本1274例。结果:1274例上呼吸道核酸标本检测阳性率为2.59%,假阴性率为0.24%,标本合格率为99.68%,医务人员操作技能掌握率为100.00%,采样部位正确率为99.92%,采样手法正确率为99.84%,空气与物体表面细菌学检测合格率为100.00%,工作人员零感染。结论:基于Donabedian三维理论制定的上呼吸道核酸检测标本采集管理策略可提高标本合格率、预防交叉感染,为建立科学严谨的核酸检测质量管理体系提供参考借鉴。

Quality management of the nucleic acid detection sample collection via upper respiratory tract based on Donabedian structure-process-result theory

Objective:To analyze the overall quality management on COVID-19 nucleic acid specimen collection based on the Donabedian structure-process-result theory.Methods:To identify associated factors related to the quality control of upper respiratory tract nucleic acid collection,to formulate the implementational strategies on sample collection according to Donabedian structure-process-result theory,and to apply these strategies to 1274 cases of suspected COVID-19 individuals and related groups in our hospital from January 23,2020 to February 17,2020.Results:The overall positive rate was 2.59%among all screened individuals,with the false negative rate being 0.24%.The rate of the qualified samples remained at 99.68%.Medical staff reported with 100.00%in mastering the operational skills during sample collection,and the rates of correct sampling in terms of location and method were 99.92%and 99.84%,respectively.The qualified rate on bacteriological detection in air and surfaces was 100.00%,and no infected case was reported among medical staff.Conclusion:The collection and implementation strategy of nucleic acid sampling via upper respiratory tract based on Donabedian structureprocess-result theory can improve the qualified rate of collected samples,prevent cross infection,therefore provide references for establishment of a scientific and rigorous nucleic acid detection quality management system.