Résumé
Objective To investigate current situation of Chinese clinical microbiological laboratories participating in management of healthcare-associated infection and antimicrobial use.Methods Fourteen provinces (municipalities), autonomous regions and army hospitals in seven regions of China were selected, the participation of clinical microbiological laboratories in the consultation of HAI diseases, specimen quality control, antimicrobial use, and management of multidrug-resistant organisms (MDROs) before 2000 and every five years from 2000 to 2015 were investigated, the surveyed results were analyzed statistically.Results A total of 187 hospitals were investigated, in 2015, 96 and 172 hospitals (51.34％, 91.98％) participated in the consultation of infectious diseases and multi-department collaborative management on MDROs respectively.However, 44 hospitals (23.53％) still manually performed statistical analysis on drug susceptibility, only 26 hospitals (13.90％) had the ability of identifying homology of pathogens.Rate of MDRO surveillance data feedbacked to clinical departments increased from 66.84％ (n=125) in 2010 to 95.72％ (n=179) in 2015, the frequency of feedback was mainly monthly and quarterly;rate of antimicrobial susceptibility results feedbacked to clinic departments increased from 62.03％ (n=116) to 94.12％ (n=176), 82.35％ (n=154) of clinical microbiological laboratories conducted quarterly feedback;the quality control rate of microscopic sputum smear before sputum culture increased from63.10％ (n=118) to 87.17％ (n=163);rate of bilateral double blood culture increased from 35.83％ (n=67) to 72.73％ (n=136);rates of other aseptic body fluid culture (except blood and urine) increased from 4.86％ to 5.74％;differences were all significantly different between 2010 and 2015 (all P＜0.05).Conclusion Clinical microbiological laboratories have played an important role in promoting the development of HAI management in China, especially during the period of 2011-2015.However, the homology analysis on HAI pathogens, informatization of result feedback, and sterile body fluid specimens detection need to be further strengthened.
Résumé
Objective@#To establish the information solution for the classification and assessment of specimen quality based on the assembly line. @*Methods@#Before the samples entered into the assembly line, they were took pictures and screened by the image results. For the suspected samples, serum index was detected. Then, the classification criteria of specimen quality were set, and the alarm thresholds of serum indices for each item suitable for our laboratory were established. The results of serum indices were compiled into the corresponding text descriptions and automatically written into the notes of the result reports. The pictures of blood collection tubes were stored in the laboratory information management system (LIMS) and could be accessed at any time for verification. The samples intercepted by the automatic review were further reviewed by manual. @*Results@#The intra-assay coefficients of variation (CV) of serum indices for haemolysis (H), lipaemia (L) and icterus (I) were 0.6%, 0.7% and 1.3%, respectively, indicating that the precision was good. Among 657 770 samples detected by the assembly line, 11.9% of samples were screened out before they entered the assembly line. The detection of serum indices of these samples demonstrated that the samples with haemolysis, lipaemia and icterus accounted for 1.6%, 1.2% and 0.3% of the total samples, respectively. According to the results of the interference experiment, the alarm threshold of hemolytic serum index was set in 11 items, and those of lipaemia and icterus were set in 1 item. @*Conclusion@#By establishing the information solution of specimen quality based on the assembly line, the real-time classification prompting of specimen quality is realized, and the missed detection is avoided, which is helpful to reduce the pre-analysis errors caused by serum quality and simplify the laboratory workflow.
Résumé
objective@#To explore the effect of Standard Operating Procedure on the management of venous blood specimens before laboratory.@*Methods@#Blood collection SOP was established and applied on the management of venous blood specimens before laboratory.Nursing capacity,complication rate,rate of unqualified blood specimens were compared between before and after the SOP applying.@*Results@#Before and after the applying of SOP, the blood collection capacity of nurses were 85.43±5.07,91.28±4.78,the differences were statistically significant(t=-8.104, P=0.024). Before the applying of SOP, amounts of complication about venous blood collection, unqualified blood specimens and unqualified blood specimens which lead by nursing factors were 21, 95, 51, while after the applying, the amounts were 9, 63, 21, the differences were statistically significant (χ2=4.887, 6.052, 6.325, P<0.05).@*Conclusion@#Application of Blood collection SOP can promote nursing capacity of blood collection and reduce the incidence of unqualified venous blood specimens,improve the quality of venous blood specimens.
Résumé
objective To explore the effect of Standard Operating Procedure on the management of venous blood specimens before laboratory. Methods Blood collection SOP was established and applied on the management of venous blood specimens before laboratory.Nursing capacity,complication rate,rate of unqualified blood specimens were compared between before and after the SOP applying. Results Before and after the applying of SOP, the blood collection capacity of nurses were 85.43 ± 5.07,91.28 ± 4.78,the differences were statistically significant(t=-8.104, P=0.024). Before the applying of SOP, amounts of complication about venous blood collection, unqualified blood specimens and unqualified blood specimens which lead by nursing factors were 21, 95, 51, while after the applying, the amounts were 9, 63, 21, the differences were statistically significant (χ2=4.887, 6.052, 6.325, P﹤0.05). Conclusion Application of Blood collection SOP can promote nursing capacity of blood collection and reduce the incidence of unqualified venous blood specimens,improve the quality of venous blood specimens.