目的探讨PDCA(循环管理)应用于临床急救用血管理的实效性。方法收集本院各临床用血科室2021年1月—2022年6月的急救用血病例资料,观察配血时间、取血时间、急救用血率,以输血科实施(验)PDCA期间(2021年7月—12月)为界,分为PDCA实验组(...目的探讨PDCA(循环管理)应用于临床急救用血管理的实效性。方法收集本院各临床用血科室2021年1月—2022年6月的急救用血病例资料,观察配血时间、取血时间、急救用血率,以输血科实施(验)PDCA期间(2021年7月—12月)为界,分为PDCA实验组(简称实验组,n=287),PDCA实验前组(简称对照组1,2021年1—6月,n=516)和PDCA实验停止后组(简称对照组2,2022年1—6月,n=277),根据科室性质做亚组分析,分别为内科、外科、ICU。对实施前阶段中非急救用血占用急救通道问题应用PDCA做持续改进;使用Kruskal-Wallis检验和χ^(2)检验比较3组间配血时间、取血时间、急救用血率的变化。结果实验组、对照组1、对照组2的配血及取血时间(M,min)分别19.00 vs 45.50 vs 23.00及22.00 vs 44.00 vs 25.00(均为P<0.05);其分别在内科为19.00 vs 47.00 vs 24.00及23.00 vs 56.00 vs 30.50、外科为18.00 vs 57.50 vs 14.00及32.00 vs 41.00 vs 24.00、ICU为20.00 vs 42.00 vs 23.00及16.50 vs 34.00 vs 12.50(均为P<0.05)。实验组、对照组1、对照组2急救用血率分别为6.9%(287/4141)vs 11.0%(516/4689)vs 6.8%(277/4089);其分别在内科为6.3%(175/2769)vs 11.8%(297/2512)vs 6.7%(186/2789)、外科为5.9%(24/405)vs 3.6%(44/1213)vs 7.4(37/501)、ICU为9.1%(88/967)vs 18%(175/973)vs 6.8%(54/799)(均为P<0.05)。结论输血科应用PDCA能有效缩短临床急救用血的配血与取血时间,提高急救输血的成功率,应用价值明显,值得临床推广应用。展开更多
Large-scale sudden-onset disasters may cause massive injuries and thus place great pressure on the emergency blood supplies of local blood banks. When blood is in short supply, blood products gathered urgently to a lo...Large-scale sudden-onset disasters may cause massive injuries and thus place great pressure on the emergency blood supplies of local blood banks. When blood is in short supply, blood products gathered urgently to a local blood center should be appropriately allocated to blood banks in the affected area. Moreover, ABO/Rh(D) compatibilities among blood groups must be considered during emergency situations. To minimize the total unmet demand of blood products considering the optimal ABO/Rh(D)-compatible blood substitution scheme, a mixed integer programming model is developed and solved efficiently by using a greedy heuristic algorithm. Finally, a numerical example derived from the emergency blood supply scenario of the Wenchuan Earthquake is presented to verify the proposed model and algorithm. The results show that considering ABO/Rh(D)-compatible blood substitution can remarkably increase the efficiency of emergency blood allocation while lowering blood shortage, and the preference order of possible ABO/Rh(D)-compatible substitutions has an influence on the allocation solution.展开更多
文摘目的探讨PDCA(循环管理)应用于临床急救用血管理的实效性。方法收集本院各临床用血科室2021年1月—2022年6月的急救用血病例资料,观察配血时间、取血时间、急救用血率,以输血科实施(验)PDCA期间(2021年7月—12月)为界,分为PDCA实验组(简称实验组,n=287),PDCA实验前组(简称对照组1,2021年1—6月,n=516)和PDCA实验停止后组(简称对照组2,2022年1—6月,n=277),根据科室性质做亚组分析,分别为内科、外科、ICU。对实施前阶段中非急救用血占用急救通道问题应用PDCA做持续改进;使用Kruskal-Wallis检验和χ^(2)检验比较3组间配血时间、取血时间、急救用血率的变化。结果实验组、对照组1、对照组2的配血及取血时间(M,min)分别19.00 vs 45.50 vs 23.00及22.00 vs 44.00 vs 25.00(均为P<0.05);其分别在内科为19.00 vs 47.00 vs 24.00及23.00 vs 56.00 vs 30.50、外科为18.00 vs 57.50 vs 14.00及32.00 vs 41.00 vs 24.00、ICU为20.00 vs 42.00 vs 23.00及16.50 vs 34.00 vs 12.50(均为P<0.05)。实验组、对照组1、对照组2急救用血率分别为6.9%(287/4141)vs 11.0%(516/4689)vs 6.8%(277/4089);其分别在内科为6.3%(175/2769)vs 11.8%(297/2512)vs 6.7%(186/2789)、外科为5.9%(24/405)vs 3.6%(44/1213)vs 7.4(37/501)、ICU为9.1%(88/967)vs 18%(175/973)vs 6.8%(54/799)(均为P<0.05)。结论输血科应用PDCA能有效缩短临床急救用血的配血与取血时间,提高急救输血的成功率,应用价值明显,值得临床推广应用。
基金supported by the National Natural Science Foundation of China(Nos.71502146,71672154,and 90924012)Humanities and Social Sciences Foundation of the Ministry of Education of China(No.16YJA630038)
文摘Large-scale sudden-onset disasters may cause massive injuries and thus place great pressure on the emergency blood supplies of local blood banks. When blood is in short supply, blood products gathered urgently to a local blood center should be appropriately allocated to blood banks in the affected area. Moreover, ABO/Rh(D) compatibilities among blood groups must be considered during emergency situations. To minimize the total unmet demand of blood products considering the optimal ABO/Rh(D)-compatible blood substitution scheme, a mixed integer programming model is developed and solved efficiently by using a greedy heuristic algorithm. Finally, a numerical example derived from the emergency blood supply scenario of the Wenchuan Earthquake is presented to verify the proposed model and algorithm. The results show that considering ABO/Rh(D)-compatible blood substitution can remarkably increase the efficiency of emergency blood allocation while lowering blood shortage, and the preference order of possible ABO/Rh(D)-compatible substitutions has an influence on the allocation solution.
