| Blood transfusion, as an important medical resource, is a clinical therapy in modern medical care that cannot be replaced. Whereas, blood transfusion, as well as most other clinical therapies, has many risk factors because of the current low level of technology and management, etc. Blood donors may be infected with pathogens, and transfusion recipients may be infected with a variety of infectious diseases, and may experience transfusion risks, such as transfusion reactions, transfusion errors, etc, in the process of transfusion. Therefore, transfusion recipients and their family members may suffer from serious physical and psychological damages due to blood transfusion, and transfusion risks are ubiquitous. But blood transfusion is an indispensable medical means in spite of the risks, so we have to face the fact objectively and study the therapy carefully, and try to predict and control the risks in blood transfusion. Therefore, how to reduce the risks in blood transfusion becomes one of the most urgent problems in the field of blood transfusion. With a purpose to study and analyze the clinical risks in blood transfusion and to propose corresponding preventive measures, this article analyzes the transfusion risks in the following aspects and proposes several corresponding preventive measures to reduce the chances of the risks, to protect the interests of the patients and the rights and interests of the medical institutions, and to provide a reliable theoretical basis for the preparation of medical norms by medical institutions and health authorities.1. A questionnaire survey form was designed with the aim of fully understanding the current conditions of the blood transfusion departments in hospitals and to find out the problems, through investigating the current personnel structures of the blood transfusion departments in 28 tertiary hospitals and 76 secondary hospitals in Shandong Province.2. A retrospective analysis was conducted of the data on the infection indexes and infection rate of the patients who applied for blood transfusion in our hospital in last year, and the data was compared with the infection conditions of the blood donors. And based on the above investigation and studies, the current risks in blood transfusion are assessed and analyzed, and corresponding preventive measures were proposed to improve the safety in blood transfusion.All the hospitals investigated had the capability of purchasing blood from a blood center according to the requirements of the Ministry of Health of the PRC, the conventional equipment of the tertiary hospitals could meet the basic need of the transfusion departments, and the conventional equipment of the secondary hospitals and lower-grade hospitals were of poorer conditions and outdated, and the blood transfusion departments of most of the secondary hospitals were not independently established. Only few of the blood transfusion departments of the universities' affiliated hospitals among the 104 hospitals were engaged in teaching, and only 7 hospitals undertook municipal or higher level research projects. All except one of the 28 tertiary hospitals investigated were involved in the In-door Quality Control Program and all took in-door quality control measures from 2008, as required by the Ministry of Health. Only 12 of the 76 secondary hospitals investigated were involved in the in-door quality control program, accounting for 15.97% of all the secondary hospitals; among which,56 took in-door quality control measures, accounting for 73.68% of all the secondary hospitals.28 tertiary hospitals conducted cross matching according to the clinical standards by the Ministry of Health, but 26 of the 76 secondary hospitals (accounting for 34.21%) adopted the brine method in blood matching, which greatly increased the risks in blood transfusion. The grades of the professional titles and academic credentials of the practitioners in 104 hospitals were too low, and there were only 16 who had obtained the master's or higher level degrees in all the tertiary hospitals in Shandong Province (accounting for 7.41%), and only 2 in the secondary hospitals (accounting for 0.91%). The current situation of the personnel of the blood transfusion departments in the hospitals in Shandong Province are not optimistic. Therefore, it is recommended that practioners of higher levels should be employed, and more efforts should be devoted to teaching and scientific research, so as to enhance the overall level of the blood transfusion departments of the hospitals in Shandong Province. According to the survey of the infection indexes of the appliers for blood transfusion in our hospital in last year, the infection rate of the 13276 recipients was 8.20%(1088/13276), significantly higher than that of the normal population (the donors that year), P＜0.001. The differences between the departments of higher positive rate, i.e. departments of internal medicine, departments of surgery, departments of oncology, departments of hematology, was statistically significant(χ2=227.14, P<0.001). Comparison of infection conditions between the two genders:no significant difference between hepatitis B, hepatitis C, and hepatitis A, P>0.05; significant difference in syphilis infection, P<0.05. The results show that there are still problems in the blood transfusion in Shandong Province.Based on the advanced experience in blood transfusion from foreign hospitals and the conditions of the hospitals in Shandong Province, the author proposes the following suggestions measures for prevention of the risks in blood transfusion:to strictly implement the Technological Norms of Clinical Blood Transfusion by the Ministry of Health, strictly test the infection indexes in blood transfusion, and promote autotransfusion to reduce the risks in blood transfusion; to strengthen the training of clinicians, actively promote methods of scientific and rational use of blood, so as to reduce the necessity for transfusion; to strengthen the training of the personnel of the blood transfusion departments, employ high-quality personnel to promote the development of clinical blood transfusion; to regulate the internal management of the blood transfusion departments so as to ensure the effective implementation of the Technological Norms of Clinical Blood Transfusion; actively promote the development of the blood transfusion departments, urge the blood transfusion departments to participate in the Inter-door and In-door Quality Control Programs by the Ministry of Health and the provincial health authorities, improve the level of blood tests, so as to avoid accidents and errors in blood transfusion; to establish blood transfusion insurance mechanisms to shift the risks of blood transfusion. The above-mentioned measures may help to improve the safety of clinical blood transfusion. |
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