急诊红细胞输注申请结果报告时间分析

目的对急诊红细胞输注申请的结果报告时间(turnaround time,TAT)进行监测,了解影响急诊输血申请TAT的因素,促进输血科持续质量改进,同时为制定急诊输血处理流程提供依据。方法观察各个临床科室急诊红细胞输注从医生开出输血申请到合血标本采集、标本运送、标本检测不同时间段所占的时间,找出影响标本处理总时间的因素,计算输血科处理急诊标本的平均时间。结果从临床开出输血申请到输血科完成交叉合血(总TAT),中位数时间为138 min,最短为17 min。从输血申请送到输血科到完成交叉合血,中位数时间为55 min。从开出输血申请到血液取用,中位数时间为221 min,最短为21 min,最长为4 266 min(71 h)。所有急诊红细胞输注申请中,约有70%的红细胞被取回输注,交叉合血:输血比例为1.4∶1。随着总TAT时间的延长,标本采集时间和标本运送时间所占比例逐渐下降,而标本检测时间所占比例逐渐上升。结论目前将急诊输血取血时间定为1 h较为符合实际情况;部分临床医生开急诊输血申请较为随意;输血科对部分急诊标本处理不够及时。

Analysis of the turnaround time of emergency RBC transfusion requests

objective To investigate the turnaround time(TAT) for emergency RBC transfusion request.Methods The time points of emergency red cell transfusion request,blood specimen collection,reception by transfusion service,fulfillment of pretransfusion testing,blood issue were recorded by hospital information system or laboratory information system and TAT was calculated.Results The median time period from transfusion request to the fulfillment of pretransfusion testing was 138 minutes,the shortest time being 17 minutes.The median time for the transfusion service to process the transfusion request was 55 minutes.The median time from transfusion request to blood issue was 221 minutes,the shortest and the longest being 21 and 4 266 minutes,respectively.Seventy percent of the emergently requested red cell unites were transfused to the patients,with a cross match to transfusion ratio of 1.4∶1.Conclusions The time required for the transfusion service to finish the processing of emergency red cell transfusion request is about 1h in a large tertiary care institutional hospital.Some orders of emergency transfusions are not appropriate.Transfusion service needs to take measures to process every emergency transfusion request as soon as possible.