運用真空採血器降低心臟科病房血液檢體溶血率之成效

The Effect of Using Vacutainer Blood Collection Tubes to Decreased the Hemolysis Rate of Blood Samples in Cardiology Wards

背景：單位2016年度總退檢率2.26％，高於全院平均退檢率1.34％，其檢體溶血率1.61％，檢體溶血率高引發專案動機，分析原因：1.未落實靜脈採血標準作業；2.靜脈採血認知不足；3.真空採血器使用率低；4.無真空採血相關教育與流程。目的：期經專案措施介入後單位檢體溶血率能降低40％，由1.61％降至≦0.96％。解決方案：成立輔導小組、季稽核靜脈採血標準作業、月稽核溶血率、舉辦靜脈採血在職教育與教育訓練、增設真空採血器、行動護理車設立採血用具專區、新進人員抽血技術考核、建立真空採血器組裝方式圖卡、推動真空採血器。結果：經計畫執行後評值成效，血液檢體溶血率由1.61％降至0.65％，達到專案目標值。結論：經真空採血器運用專案實施後，能降低血液檢體溶血率。

Background: The total specimen rejection rate of the investigation unit in 2016 was 2.26%, which was higher than the average rate of retreat in 2016 of the hospital by 1.34%. The hemolysis rate of the specimen was 1.61%. The high hemolysis rate of the specimen caused the motive of the project. The reasons for the analysis: 1. The standard operation of venous blood collection was not implemented. 2. Insufficient cognition of venous blood collection; 3. The low utilization rate of vacuum blood collection tube 4. the technical process and education by collection of venous blood wasn't setting up. Objective: The hemolysis rate can be reduced by 40%, from 1.61% to ≦0.96%. Method: Assistance team was established and quarterly nuclear venous blood sampling standard operation, monthly auditing nuclear hemolysis rate, holding intravenous blood inservice education and education training for vacuum blood collection tube, setting up blood collection equipment area on the portable nursing car, auditing for new personnel blood drawing, establishing vacuum collection of blood tube assembly mode card to promote usage rate. Result : The hemolysis rate of the blood sample decreased from 1.61% to 0.65%, reaching the target value of the project. Conclusion: Using a vacuum blood collection device can reduce the hemolysis rate of samples.