ABSTRACT
To cultivate high-quality professionals of transfusion medicine and construct a new mode of undergraduate practice of transfusion medicine. Since 2013, orientation interns in blood transfusion medicine were recruited from the undergraduate program of laboratory medicine, and a new teaching mode of orientation practice of blood transfusion medicine was established from the aspects of teaching staff, rotation of posts, practice content and comprehensive quality. Through the new training mode of orientation practice, excellent transfusion medical professionals with solid basic knowledge, strong operational skills and high comprehensive quality were cultivated. The establishment of the oriented practice mode of blood transfusion medicine is beneficial to the cultivation and output of high-quality transfusion talents and plays a positive role in promoting the development of transfusion medicine education.
ABSTRACT
【Objective】 To explore platelet antibody production and its influencing factors in common platelet transfusion diseases. 【Methods】 From January 2018 to June 2020, patients who applied for platelet transfusion in the First Affiliated Hospital of Chongqing Medical University were enrolled. The solid phase agglutination method was used to detect the platelet antibodies of the patients. The platelet antibody positive rate of common platelet transfusion diseases and the types of diseases with higher platelet antibody-positive rates were analyzed. 【Results】 The overall positive rate of platelet antibodies in transfusion candidates was 15.0%. The 21~40 years old age patients(21.5%), females(18%) had a significantly higher platelet antibody positive rate than other ages and males(12.1%) (P<0.05). Besides, patients with a history of blood transfusion and pregnancy also had a higher platelet antibody positive rate. Tumors, blood and hematopoietic organ diseases, and digestive system diseases have higher platelet antibody-positive rates, which were 24.0%, 18.3%, and 16.6%, respectively. The platelet antibody positive rate varies significantly in common platelet transfusion diseases. As to transfused patients stratified by diseases, the platelet antibody positive rate of myeloid leukemia(48.7%)was higher than that of other diseases(P<0.05). In comparison, the platelet antibody positive rate of non-transfusion patients with liver failure and miscellaneous diseases(46.7%)was higher than that of others (P<0.05). 【Conclusion】 The positive rate of platelet antibody is somewhat higher in female, 21~40 years old patients. History of blood transfusion is a key risk factor for the production of platelet antibodies.
ABSTRACT
【Objective】 To analyze the root causes of adverse events to insufficient plasma transfusion, so as to explore improvement measures, optimize the transfusion strategy and avoid such adverse events. 【Methods】 The root causes of insufficient plasma transfusion were analyzed by health care failure mode and effect analysis, the targeted improvement measures were formulated and the effect was evaluated. 【Results】 After the improvement, the incidence of adverse events to insufficient plasma transfusion decreased significantly.The risk priority value affecting the safety of blood transfusion decreased from 70 to 8, and the proportion of coagulation function test after blood transfusion increased from 44.61%(1 309/2 934)in 2012 to 80.55% (2 187/2 715)in 2019, and plasma transfusion volume per capital increased from 300 mL to 528 mL. PT and APTT values after plasma transfusion in 2019 significantly increased compared with those in 2012. Meanwhile, the proportion of plasma transfusion in hospitalized patients decreased from 3.16% (2 934/92 838)to 2.12%(2 715/128 352). 【Conclusion】 Risk management of quality and safety of blood transfusion by combing healthcare failure mode, effect analysis and root cause analysis(RCA) can improve the risk awareness of clinical blood transfusion, optimize the proportion of plasma transfusion, and is essential to ensure the safety and effectiveness of blood transfusion and improve the prognosis of transfused patients.