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背景 由于输注压积红细胞(RBCs)存在许多危险,因而只有在必须的时候才输RBCs。在美国奥马哈Veterans Affairs教学医院实施了一项全医院范围的教育计划,以改善输血服务质量及为血库血液使用审核提供一条渠道。研究设计和方法 该计划要求临床医生填写一份资料卡,资料卡上列有合适的输血标准。审核这些资料卡后判断其输血是否符合标准。如果输血被认为不符合标准,稍后医生会受到书面提醒注意。该资料卡于1989年在未审核的情况下自愿的基础上使用,1990年开始强制性实行。输血率和死亡率用患者住院天数校正,并用卡方进行分析。结果:自愿应用资料卡时未降低输血率,在1989年至1990年强制性应用期间患者住院每天的RBC输血单位数下降26％(P<0.001)。在随后几年里RBC输血持续减少。这段
Background Because of the many dangers of transfused red blood cells (RBCs), RBCs are only lost when necessary. A hospital-wide education program was implemented at the Veterans Affairs Teaching Hospital in Omaha, United States, to improve the quality of blood transfusion services and provide a channel for auditing blood bank blood use. Study Design and Methods The plan requires the clinician to complete a data card that lists the appropriate transfusion criteria. After reviewing these data cards, judge whether the blood transfusion complies with the standard. If the transfusion is deemed not to meet the criteria, the doctor will be reminded in writing later. The data card was used on a voluntary basis in 1989 when it was unapproved, and mandatory implementation began in 1990. Transfusion rates and mortality were adjusted using the days of hospital stay and analyzed using Chi-square. RESULTS: The voluntary use of the data card did not reduce the transfusion rate, and the number of RBC transfusion units per day of hospitalization during the mandatory application period from 1989 to 1990 decreased by 26% (P<0.001). In the following years RBC transfusions continued to decrease. This paragraph