病人护理

Our commitment to patient safety.

Application for Initial Listing as a Patient Safety Organization (PSO)

指定的验血西北作为病人亚搏手机客户端app下载afety Organization (PSO) would allow BloodworksNW to perform patient safety improvement functions undertaken routinely by hospital-based transfusion services.

收集血液后，将成分加工成分，测试和标记，尚未准备输血。必须对来自预期接受者的样本进行额外的测试，以确定患者的ABO组和RH类型以及存在任何意外抗体。最后，必须对单位的交叉匹配进行红细胞单元。这些附加步骤称为“预输送测试”。

In almost all hospitals, this testing is performed by a transfusion service laboratory (TSL), part of the hospital’s clinical laboratories. From this intra-institutional location, the laboratory has access to data regarding the performance of not only its functions but also of the “pre-analytic” and “post-analytic” functions performed at the bedside that are critical to a safe transfusion process. These include, for example, identification of the patient at the time of collection of the pre-transfusion specimen and at transfusion. Thus the TSL is in a position to gather data about procedural deviations and near-miss events (“incidents”) in a manner protected in most states by a quality assurance system. After analyzing these occurrences, the TSL staff can work with others to improve care.

Since its formation in 1944, BloodworksNW has served as the centralized TSL for all hospitals in King County, Washington. This metropolitan Seattle area today includes 19 hospitals that transfuse over 100,000 units of red cells annually in addition to 40,000 units of plasma and 25,000 platelet transfusions. All pretransfusion testing is conducted in one of four laboratories operated by BloodworksNW, and blood is delivered to the hospitals ready for transfusion. Medical expertise in transfusion medicine is similarly concentrated at BloodworksNW with its specially trained physicians serving as the transfusion consultants for all 19 hospitals and providing expertise to their transfusion committees.

亚搏手机客户端app下载Bloodworksnw在整个King County推广了输血安全官员（TSO）的概念。在输血医学中具有特殊培训的护士在每个较大的医院协调问题和调查事件时工作。TSO总部位于血液中心寻求与实验室运营协调其活动和界面，调查输血反应并处理医院出现的临床上血问题。

该系统提供了稀缺，经济利用稀缺的血资资源，并促进整个社区的输血问题的凝聚力。然而，它受到在此过程中涉及的多个机构的阻碍，每个机构都有略有不同的方法，可能不愿意分享有关不必要事件的信息。虽然BloodWor亚搏手机客户端app下载ksnw TSL接收来自King County的所有医院的（并调查）输血反应的报告，但事故通常是未知的血迹，并且不容易与导致的输血反应相关。

The US Biovigilance Network (USBVN), a public-private partnership involving HHS, CDC and the AABB (among others), provides hospitals across the country the opportunity to capture and categorize transfusion reactions (“events”) and incidents in a standardized way and confidentially compare their institution’s performance with system data. This allows the identification of areas of weakness in their systems and of benchmarks to attain. Accumulation of both event and incident data in one system allows identification of the connectivity between antecedent events with patient outcomes so that system improvements can be sought. (Transfusion 2007;47:1937-42.)

USBVN的应用在King County中受到阻碍，因为传输过程中涉及的多方都没有完全访问与其系统有关的所有数据，并且可能是终于让其他人可以访问数据，其披露可能会被推动。例如，国王县的若干机构是世界着名的，致力于患者安全改进，但他们的数据在自身质量改进系统之外共享时失去了安全性。

Designation of BloodworksNW as a PSO would allow full sharing of transfusion process-related data within our system, maximizing the improvement capabilities of the USBVN. BloodworksNW’s TSL would continue to gather data about patient events and would enter those into the USBVN noting the location (including the institution) where they had occurred. Data regarding incidents would be entered into the USBVN by individual hospitals for national (confidential) compilation as well as local application. The hospitals in King County using the BloodworksNW TSL could then give confidential access to their data to the BloodworksNW PSO. This would allow BloodworksNW to link events with incidents and would also allow compilation of incident data across King County. Just as the USBVN will analyze events and incidents and propose patient safety improvement policies nationally, the BloodworksNW PSO will be able to assess the performance of different hospitals’ systems and work toward improving transfusion safety across all the institutions it serves. In essence, the designation of PSO status to BloodworksNW would give back to this transfusion system the confidential omniscience it loses by having the TSL separated from the institutions in which the remainder of the process occurs. (Transfusion 2003;43:1190-9.)

亚搏手机客户端app下载BloodWorksnw已经拥有医疗领导，员工和基础设施，以管理通过指定作为PSO提供的数据。辅助八种输血医院医师和注册护士TSO的医疗主任将负责组装分析数据。亚搏手机客户端app下载BloodWorksnw的标准操作程序已经包含有关它所服务的患者个人健康信息的机密性要求，这些方法将应用于通过合同的机构维持对血腥的血统可用的数据提供的数据。将与现有的医疗咨询委员会（由医院医生组成）共享汇总和解除识别的数据以进行讨论和进一步分析。所有数据都将被提出，以便无法辨别各个事件或事件的起源，并且维护机构（和患者）保密。分析将以类似于计划的AABB PSO计划的方式进行。然后，改善输血过程和改善患者安全的计划将在所有国王县医院实施PSO分析的实力。