Evaluating the Efficacy of Pre-Transfusion Test by Implementing the Common-Tube Strategy for Inpatients

評估血液檢體共管以提升住院病患備血效能

背景：住院病患通常需要進行很多項的實驗室檢查，每一個檢查項目的檢體都必須單獨採集，這導致病患被抽取大量血液並增加被針頭注射的頻率。在臨床上常常利用全血細胞計數檢測（CBC）來監測住院病患的治療效果。因此，我們將CBC檢測的樣本分享給輸血前檢測，以評估對住院病患實施共管策略的優勢。
方法：有兩種實踐方式：一種是當醫生醫囑的內容僅做輸血準備時，現有的CBC檢體可用於輸血前檢測。另一種方式是，當醫囑為同時進行CBC檢測和輸血準備時，只抽取一管血液進行CBC檢測，而不另外抽取一份血液樣本進行輸血前檢測。
結果：以2020年住院人數分析共管策略的成效。與分別抽取血液檢體相比，結果顯示在共管策略中成本降低新台幣3,513元、採集時間縮短至29,120分鐘，傳染性廢物減少到104,830克。

Background : For inpatients, many laboratory tests are required, and the specimens must be collected separately. This results in a large amount of blood being collected and an increase in needle puncture frequency. In clinical practice, the complete blood count (CBC) test is often used to monitor the treatment effect on inpatients. Therefore, we implemented a common-tube strategy for inpatients by sharing the specimens for the CBC test with the pre-transfusion testing.
Methods : There are two implementations: one is that when the doctor orders only blood preparation, the existing CBC specimen can be used for a pre-transfusion test. Another way is that when the doctor orders CBC testing and blood preparation at the same time, it can only draw off one tube of specimen for the CBC test without drawing another blood sample for the pre-transfusion test.
Results : The effectiveness of the common-tube strategy was analyzed based on the number of inpatients in 2020. Comparing to drawing the samples respectively, the results showed that the cost was reduced by 3,513 NT dollars, the collection time was reduced to 29,120 minutes, and the infectious waste was reduced to 104,830 grams by adopting the common-tube strategy.
Conclusion : Although there are many advantages to the common-tube strategy, there are still some urgent problems that need to be addressed in the future, such as reducing the time taken by searching for the specimens and developing a process to avoid delays in blood transfusions when CBC specimens cannot be shared.