運用多元策略降低加護病房血液檢體異常發生率

Reducing the Incidence of Abnormal Blood Specimens in the Intensive care unit Through Multimodal Strategies

目的
檢驗數據為臨床疾病診斷與治療成效追蹤之重要依據。本單位2022年血液檢體異常發生率為0.95％，高於同院區內科加護病房之0.50％，影響檢驗結果正確性與醫療決策品質，故成立專案小組降低血液檢體異常發生率並提升採檢正確性。
方法
透過多元改善策略，包括：舉辦「生命之水—血液」教育訓練、製作血液採檢教學影片、設計「血液採檢饒舌節奏廣播」提醒機制、製作彩虹試管圖卡強化採血順序、於試管條碼標示正確搖晃次數、設置血液穿刺聚寶盆集中用物及導入困難採檢輔助工具。
結果
方案實施後，血液檢體異常發生率由0.95％降至0.50％；血液採檢認知正確率由71.4％提升至96.0％；血液採檢執行正確率由55.1％提升至93.2％，均達專案預期目標。
結論
透過多元且創新之改善策略，有效提升護理人員血液採檢認知與執行能力，顯著降低檢體異常發生率。建議未來可持續推廣標準化採檢流程與輔助工具，以確保檢驗品質並提升整體病人安全。

Purposes
Laboratory data are essential for clinical diagnosis and the monitoring of treatment outcomes. In 2022, the incidence of abnormal blood specimens in this unit was 0.95%, exceeding the 0.50% benchmark established by the hospital’s medical intensive care unit. This discrepancy compromised the accuracy of laboratory results and the quality of clinical decision-making. Consequently, a project team was established to reduce the incidence of abnormal blood specimens and optimize blood collection practices.
Methods
A series of multimodal improvement strategies were implemented, including an educational program titled“The Water of Life-Blood,”instructional videos demonstrating proper blood collection techniques, and a rap-style rhythmic reminder designed to reinforce correct blood collection practices. Additional measures included the use of color-coded reference cards to standardize the order of draw, the application of barcode labels indicating the appropriate number of tube inversions, the establishment of a centralized venipuncture kit, and the introduction of assistive devices for challenging blood draws.
Results
Following implementation, the incidence of abnormal blood specimens decreased from 0.95% to 0.50%. The knowledge accuracy rate for blood collection improved from 71.4% to 96.0%, and the procedural accuracy rate increased from 55.1% to 93.2%. All outcomes met the expected targets for the project.
Conclusions
These multimodal and innovative strategies effectively enhanced both the knowledge and performance of nursing staff regarding blood collection, resulting in a substantial reduction in specimen abnormalities. Continuous promotion of standardized blood collection procedures and the integration of assistive tools are recommended to ensure test quality and further improve patient safety.