คุณภาพการตรวจหมู่เลือด ABO และ Rh(D) ของห้องปฏิบัติการในประเทศไทย ปีงบประมาณ พ.ศ. 2545-2548
คำสำคัญ:
External quality assessment, Quality of ABO and Rh groupingบทคัดย่อ
Abstract:
The main objective of the present study was to review and analyze the External Quality
Assessment (EQA) evaluation results of the ABO and Rh(D) blood groupings of various laboratories in
Thailand. Samples of red blood cells suspended in Alsever’s solution and serum samples were sent
to 622, 654, 568 and 636 participating laboratories of both government and private hospitals during the
fiscal year 2002 to 2005, respectively. The responded test results were analyzed and evaluated for the
standard scores which ranged from excellent (= 4), very good (<4 ≥ 3.5), borderline (<3.5 ≥ 3.0) and
unacceptable (<3.0). There were 53% (331/622), 69% (452/654), 80% (456/568) and 78% (496/636) of the
participating laboratories continuously reported back the test results for each fiscal year, respectively.
Among these, 94% (311/331), 93% (420/452), 95% (432/456) and 95% (473/496) of the laboratories had
acceptable evaluation results (borderline to excellent) in ABO blood grouping and there were 97% (281/
289), 99% (397/400), 100% (421/421) and 99% (470/476) in Rh(D) blood grouping. Hence, there were 8%
(28/331), 6% (26/452), 5% (23/456) และ 5% (23/496) and 3% (8/289), 0.7% (3/400), 0% and 1% (6/496) of
laboratories had unacceptable evaluation results in ABO and Rh(D) grouping of each fiscal year, respectively.
Moreover, 1% (3/289), 0.2 (1/400), 0% (0/421) and 0.8% (4/476) of the laboratories had unacceptable
results for both ABO and Rh(D) blood grouping during the years in 2002-2005, respectively. The main
errors involved human error, e.g. report incorrect blood group, transposition error, incomplete recording
the results, miss interpretation, discrepancy results between cell grouping and serum grouping as well
as the management problems, e.g. no serofuge, difficulty in acquiring the ABO standard cells. Fully
implementation of the quality management system and improving the relationship between the top
management and laboratory personnel could help solving these problems.
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