输血实验室室间与室内质控规范PPT参考课件.ppt

输血实验室室间质控 * WHO-室间质量评估项目(EQA) EQA目标:在所有的世界卫生组织成员国中建立一个对输血机构的质控体系进行监控的机制 EQA的益处 对参加的实验室本身 对所有的参加者 一般信息 实验室之间的比较 监测技术发展水平 促进改善与提高 * 血型血清学WHO IEQAS 监测实验的： 技巧与技术 操作者的熟练程度 实验的步骤 每年2 次 实验项目包括 ABO 定型 RhD 定型 红细胞抗体筛选 红细胞抗体鉴定 交叉配血 * 对于参加的个体 对个体进行监控 检测出实验室中实验步骤中存在的问题 与其它实验室进行比较 * 对于参加的实验室 提出忠告与培训 对实验室所用的方法，技术，试剂，试剂盒提出意建与建议 发现问题 提供可选择的相关信息 信息的交流 * EQA 计划 目的在于通过以下途径来改进相关标准 证实良好的技术 有益于提高质量 证实信息与培训 对质量是有影响 * 单个实验室中发现的问题—通过大家一起来解决 通过网络 交换信息，试剂，建议 信息整理 * EQA 不要总是期望在ＥＱＡ记录中保持“历史清白”就是好的 参与 研究ＥＱＡ中突出的问题 赴之以行动 为防止重犯而进行的体系改进 监测 * 评估的效果 改进性能 剔除落后的方法 选择适合您的技术与试剂 使实验操作技能得以改善与提高 推荐介绍更新的指导方针 * * The aim of EQA is to raise standards. Changes are difficult to measure objectively, however the parameters listed above will give some indication. UK performance has improved significantly in many areas over the last decade. We have seen positive changes in practice in terms of selection and use of reagents and techniques / technology. * ABO 6/782 0.75% reported were incorrect D 12/782 1.5% Antibody screens 26/193 6.2% false negative. i.e. 26 of the 193 results returned that should have been positive were negative. There were very few false positive results and these are not included Antibody ID - 11/139 results returned on samples containing an antibody… give unrealistic picture since only the better resourced labs attempt ID. Crossmatching - 70/309 22.7% results returned (where there should have been an incompatibility) were negative. False positives not included. Crossmatching worse than screening, possible reasons: screening cells homozygous expression of antigens cells provided for crossmatching (although in Alsevers) may deteriorate in transit - loss of more labile antigens. Suspect problems in performing IAT * Calculated in the same way as overall error rates, i.e. as number of errors dived by the number of opportunities for error. Screening and XM - false negatives only. Better than overall results… same ratio of errors Follow-up (of