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【Objective】 To explore the application effect of traditional teaching combined with problem based learning (PBL) in the teaching of transfusion medicine taking the chapter of Human Leukocyte Antigen System and Testing in Clinical Blood Transfusion Testing Technique as an example. 【Methods】 Firstly, practical problems in chapter Human Leukocyte Antigen System and Testing were analyzed. Then, in response to the key and difficult points in the teaching of this chapter, examples were given to illustrate the practical application of traditional teaching combined with PBL in the teaching of Clinical Blood Transfusion Testing Technique from the aspects of teaching objectives, teaching processes, course implementation and implementation effects. The teaching effectiveness was evaluated through a questionnaire. 【Results】 Traditional teaching combined with PBL helped students grasp important knowledge and techniques, break down thinking barriers, grasp internal connections and characteristics, simplify the learning process, stimulate interest in learning and enhance team collaboration. Meanwhile, students' exploration and innovation abilities could be further cultivated through extracurricular expansion by teachers, thus achieving ideal teaching effect. The questionnaire showed that over 90% of the students consider that combining traditional teaching with PBL was beneficial for improving teaching effect. 【Conclusion】 In the teaching of transfusion medicine, adopting traditional teaching combined with PBL according to the textbook content can improve the teaching effect, which is beneficial for the cultivation of comprehensive talents.
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【Objective】 To determine the value of quality assessment system in supervising standard clinical blood use and improving the quality of clinical blood transfusion medical records. 【Methods】 The clinical blood transfusion records of Children′s Hospital, Zhejiang University School of Medical every quarter from January 2019 to December 2022 were selected and extracted for evaluation by 5% to 10% for the current season. These blood transfusion medical records were scored and graded A(≥90 points)/B(80-89 points)/C(<80 points)according to the Evaluation Table of Clinical Science Rational Use of Blood in Children′s Hospital of Zhejiang University, and the annual A rate was statistically analyzed. After summarizing the deduction points, a rectification plan was submitted to the medical department and publicized on the hospital network. 【Results】 A total of 1 975 blood transfusion medical records were analyzed from January 2019 to December 2022, including 343 in 2019 (17.37%), 517 in 2020 (26.18%), 556 in 2021 (28.15%) and 559 in 2022 (28.30%), with Grade A rates at 67.06%, 92.07%, 93.17% and 91.06%, respectively. According to Pearson Chi-square test, the Grade A rates of blood transfusion records in 2020, 2021 and 2022 were significantly higher than those in 2019 (P<0.000 1). In the assessment, the main reasons for deduction of points were missed pre-transfusion immunization tests and missed blood transfusion course records. From 2019 to 2022, the missed rates of pre-transfusion immunization tests were 22.68%, 6.47%, 1.26% and 2.49%, and the missed rates of blood transfusion course records were 32.21%, 10.59%, 5.57% and 6.61%, respectively. 【Conclusion】 The regular and reasonable assessment and publicity system of blood transfusion medical records is conducive to improving the quality of blood transfusion medical records, promoting rational blood use and ensuring the safety of blood use for children.
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【Objective】 To analyze the data of clinical blood transfusion quality control supervision in Shanghai, so as to provide reference for the improvement of clinical blood transfusion quality management in hospitals at all levels. 【Methods】 The data of clinical blood transfusion quality control supervision in hospitals at all levels from 2016 to 2021 were retrospectively analyzed to obtain the characteristics and indicators in the quality management. 【Results】 The overall level of clinical blood transfusion quality management in Shanghai steadily improved from 2016 to 2021 (F=3.82, P<0.01), and the management level of different hospitals varied significantly (F=9.00, P<0.01). In 2021, the full compliance rates of housing facilities, instruments and equipment, diagnostic reports and medical record writing among the third-level indicators of clinical blood transfusion quality management in hospitals at all levels were as follows: 86.49%(32/37), 100% (37/37)and 43.24%(16/37) for tertiary comprehensive hospitals; 61.11%(11/18), 88.89%(16/18) and 50.00% (9/18)for tertiary specialized hospitals; 60.87%(14/23), 78.26%(18/23)and 47.83%(11/23) for secondary comprehensive hospitals, ; 60.00%(9/15), 66.67%(10/15), 40.00%(6/15) for secondary specialized hospitals; 52.38%(11/21), 38.10%(8/21), 42.86%(9/21) for private hospitals. 【Conclusion】 The characteristics of clinical blood transfusion quality management in hospitals at all levels in Shanghai differed significantly, with different strengths and weaknesses. Hospitals should improve blood transfusion management in terms of housing facilities, personnel management, system process as well as diagnostic reports and medical record writing, in order to enhance the clinical blood transfusion quality management.
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In order to solve the difficulties and challenges in the implementation of the original blood distribution and collection regulations caused by the expansion of hospital area, the extension of blood transfer time, the changeability of blood transfer environment, and the strain of personnel due to the increase of workload, as well as to ensure the accuracy of the information throughout blood remote verification and distribution and the safety of clinical blood transfusion, , Shanghai experts related to clinical transfusion and blood management had made a systematic study on the applicable scope and management rules of remote verification of blood distribution and collection, and formulated this Expert Consensus combined with the development status of digital, intelligent and remote communication technologies, so as to provide corresponding guidance for clinical medical institutions in line with the changes in reality.
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【Objective】 To evaluate the value of Six Sigma quality management method in improving the efficacy of red blood cell transfusion. 【Methods】 The five steps of definition, measurement, analysis, improvement and control in Six Sigma quality management were used to analyze the existing process capability and influencing factors, so as to formulate corresponding optimized measures and control plans for continuous improvement. The transfusion effect of RBCs in hemodynamically stable patients in our hospital from January to November in 2019 were assessed in three phases: January to March(prior to the application of Six Sigma), April to August (tracking the application of Six Sigma), and September to November(determining the effect of Six Sigma). The efficacy and process ability of RBC transfusion in patients with stable hemodynamics before and after the improvement were analyzed and compared. 【Results】 After the improvement, the effective rate of RBC transfusion for hemodynamically stable patients in our hospital increased from 76.9% to 90.5%(P<0.05). The Z value of process capacity increased from 0.408 0 to 1.330 8, with a significant improvement. 【Conclusion】 Application of Six Sigma quality management method can effectively improve the effect of red blood cell transfusion in patients with stable hemodynamics.
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【Objective】 To explore and evaluate the application of blood intelligent management platform (scheme) based on the Internet of Things(IoT)in the clinical blood management for hospitals. 【Methods】 Based on radio frequency identification technology (RFID), smart blood refrigerators, IoT blood shipping containers, automated blood bank systems, smart blood management software, etc. were developed and integrated as an IoT blood intelligent management platform (scheme). The blood storage, management software and hardware systems were organically combined, and the blood storage equipment was moved forward to the clinical departments to solve the concerns of clinicians. 【Results】 The in-depth integration of IoT technology, RFID and refrigeration technology has built an RFID-based IoT blood management solution, which integrates blood storage, transfusion, and quality control management, also realizes the entire process of supervision and traceability of clinical blood transfusion. The forward movement of blood bank to the clinical departments and the implementation of electronic cross-matching streamlined and optimized the clinical blood flow. The waiting time of patient′s for blood transfusion was shortened from (40±10) min to less than 2 min. The whole process of cold chain logistics ensured the storage quality of blood products issued, so that the clinical departments can return the untransfused blood and Blood Transfusion Department can reissue it to other hospitals. 【Conclusion】 IoT blood intelligent management based on RFID realizes the intelligent management of clinical blood transfusion and blood information traceability. The forward movement of blood bank to the clinical departments improves the efficiency of clinical blood transfusion, avoids the waste of blood source, and ensures the safety of blood transfusion. It is worth promoting in the whole process of blood transfusion.
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【Objective】 To retrospectively analyze the transfusion records of COVID-19 patients from Feb to Mar 2020 in the Optical Valley Branch of Tongji Hospital in Wuhan, and summarize the clinical features and blood use of those patients. 【Methods】 1) The utilization of blood components in 81 blood recipients were collected and retrospectively analyzed; 2) Propensity score matching (PSM, by the clinical classification of COVID-19) was used to match the transfused and non-transfused patients according to the ratio of 1∶2, and the clinical features of the two groups were compared. 【Results】 The total transfusion rate in our hospital was 5.5%(81/1 463), among which 88.9%(72/81)transfused red blood cell (RBC). Ten patients received RBC transfusion > 20 U, consumed 48.3%(330/680)RBC, 57.5%(53 500/93 100)plasma, 36.2%(42/116)platelets, and 62.3%(114.25/183.25)cryoprecipitates due to ECMO or gastrointestinal bleeding. Compared to non-transfused patients, transfused patients showed worse lab-indexes related to inflammation, infection, and coagulation at admission, higher incidences of acute liver, kidney and cardiac injury, admission to the ICU and mortality(P<0.01). 【Conclusion】 The related functional indexes and prognosis of transfused COVID-19 patients were significantly worse than non-transfused ones. RBC transfusions were dominant, and massive blood transfusions were seldom.
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Objective To study the value of the informatization clinical blood transfusion apps application in blood transfusion management under the new normal.Methods By retrospective analysis of the audit qualification rate of 16 988 general clinical blood transfusion and informatization clinical blood transfusion apps forms,and both types of analogy each stage time nodes correlation analysis.Results Review the qualification rate of the 8 616 general clinical blood transfusion form is 76.9％,the time of the doctor's advice to send is (20± 8) minutes,the time of the Blood Transfusion Department to receive is (90±48) minutes;review the qualification rate of the 8 372 informatization clinical blood transfusion apps form is 99.2％,the time of the doctor's advice to send is (3± 1) minutes,the time of the Blood Transfusion Department to receive is (2± 1) minutes.Conclusion Informatization clinical blood transfusion application form to adapt to clinical doctor operation,ensuring the safety of blood transfusion by shortening the each stage time nodes for clinical service.
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Objective To investigate the status of clinical blood transfusion from 2008 to 2014 in order to standardize clinical transfusion management and improve the clinical rational usage of various blood components .Methods By various blood compo‐nents transfusion ,the average quantity of clinical blood transfusion ,4 common blood types and the usage of red blood cells and platelet in different departments were analyzed and compared .Results The rate of blood component transfusion remained at 100%over the 2008 - 2014 year .The utilization of platelet was the highest ,followed by red blood cells and plasma ,and the amount of cryoprecipitate was the least from 2010 .The total consumption of blood was increasing each year ,but there was a downward trend at the average usage of clinical blood ,and also there were significant differences among 4 common blood types ,and the blood compo‐nent transfusion rate was different in different departments in hospital .Conclusion From 2008 to 2014 ,the blood transfusion is ap‐propriate and reasonable ,but still can be improved by effective means .
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Objective Discuss the methodology and significance of clinical transfusion assessment,establish an effective evaluation system for blood transfusion,identify rational indexes for the evaluation,and promote quality of clinical transfusion.Methods Development of the clinical blood transfusion assessment regulations,tightened blood transfusion approval system,enhanced medical record check for blood transfusion,better statistics for the data collected,and analysis of data in 2012 to compare changes in blood volume before and after tighter management in place.These efforts aim at improving the assessment system for optimal clinical blood transfusion.Results Compared to Jan.-June in 2012,patients discharged and surgical cases in Dec.of the same year dropped 2.15％ and 0.73％ respectively.However,the volume of blood transfusion decreased 22.7％,the percentage of blood transfusion for inpatients decreased from 8.78％ to 7.17％,and the average use of blood for inpatients decreased from 0.73U to 0.57U.Conclusion Reasonable and scientific assessment for blood transfusion and better clinical blood use management can improve blood transfusion therapeutic efficacy and save blood resources.