某醫學中心綜合外科病房檢體溶血及凝固之改善方案

Improvement Approach of Samples Hemolysis and Coagulation at a Surgical Ward in a Medical Center

抽血檢驗目的是為了解病患的身體狀況，根據病患的數據加以處置，但因檢體溶血及凝固的因素造成病患必須重新抽血送檢，延遲治療。現況中發現護理人員對抽血的認知達成率為57.5％，對抽血的技術行正確率為64.5％，主要缺乏抽血輔助指引及合適的送檢體容器，進而顯示檢體溶血及凝固仍有待改善，因此綜合以上缺失，進行本專案之改善方案，經過專案改善後，護理人員對抽血的認知達成率為95.9％，對抽血的技術行為91.8％，且達統計上顯著差異，輔助容器於送檢過程能適當使用，檢體溶血件數由改善前的8件/月降為為0件，血液凝固件數由改善前的2件/月降為為0件，因此透過此專案的改善後，提升護理人員對正確抽血的認知及技術，進而降低檢體溶血及凝固之發生，讓病患可儘快得到最適當的治療。

The purpose of blood testing was to evaluate physical status and provide appropriate treatment based on test results. Samples hemolysis and coagulation would inevitably cause re-drawing and consequently delay treatment. Before the improvement program was executed, the knowledge about blood drawing was 57.5% and procedure for blood drawing was 64.5% correct, indicating potential for improvement. After implementing the improvement program, the knowledge level increased from 57.5% to 95.9% and the procedure of blood drawing improved from 64.5% to 91.8% correct. After adequately using the assisting tools, the incidence of samples hemolysis and coagulation decreased from 8 and 2 incidences per month to zero. The program has been shown to be effective not only in improving the nurses’ knowledge but also improving skill of blood drawing.