運用兩種採血方法於動脈導管之檢體品質

Sample Quality of Two Types of Blood Collection from Artery Line

本研究旨在瞭解加護病房護理師運用不同採血器在已建立的動脈導管進行採血，以採血觀察表檢視其檢體品質、採血操作時間與血液曝觸之差異。本研究為實驗性設計，於2016年9－10月以某醫學中心內科加護病房病人為採血對象，分析17位護理師以隨機分派方式進行真空採血轉接頭與傳統空針執行採血。所得資料以t-test、Mann-Whitney test進行統計分析。本研究有效觀察529份（真空採血轉接頭267份，傳統空針262份），採血部位以臂動脈最多，溶血有6筆。採血操作時間以真空採血轉接頭比傳統空針明顯縮短。在溶血、凝血的發生率兩組是相似，而在血液曝觸與針扎上兩組均為零發生率。建議加護病房護理師在已建立動脈導管的病人採血時，應以真空採血轉接頭較具效率。 The study aimed to compare different blood collection devices collect blood from the arterial line in terms of specimen quality, blood collection operation time and blood exposure rate. This study uses experimental design. From September to October 2016, we performed a prospective observational study at three ICUs of a medical center in Taiwan. We measured and analyzed the operation time of blood sampling from arterial cannulation by 17 participating nurses, who were randomized to use one of the two sampling methods: Vacuum device and conventional syringe. Statistical analyses included descriptive statistics, t-test, Mann-Whitney test and Spearman rank correlation coefficient. During the study period, there were 529 valid observations of blood sampling out of 533 sessions (267 Vacuum device and 262 conventional syringe). The sampling sites were mainly from the brachial artery (67.7%). Hemolysis of the sample was found in 6 sessions, the operation times were significantly shorter in vacuum groups than in conventional groups among almost all tube numbers and type combinations. The incidence rates of hemolysis, coagulation, and blood spill over or leakage were similar. This study suggests that the ICU nurses should use the vacuum blood collection adapter to shorten the blood collection time.