Instruments and equipment purchased single or packaged purchase price is good

With the development of science and technology, testing technology is changing rapidly, a variety of testing instruments continue to enter the clinical laboratory. Due to the number of hospital beds, outpatient clinics, funds and the quality of the test staff are different, in the acquisition of instruments and management will be different, especially after China's accession to the WTO, the medical market is open to the outside world, fierce competition in the medical services industry, the laboratory in the configuration of the instrument and management of how to pay attention to the effectiveness of the Department has become a problem worthy of consideration. First, the acquisition of instruments 1, collect information: according to the number of hospital beds, outpatient volume / day, the setup of clinical departments and the number of patients in various specialties, the amount of specimens / day, as well as the original configuration of the instrument, and to consider 3-5 years after the department's business development, combined with the economic strength of the initial selection of the three brands of instruments, to make a comprehensive comparison: mainly in the performance characteristics of the instrument, such as accuracy, precision, speed of detection, barcode systems, automatic detection Function, automatic retest function, a variety of prompting functions, refrigerated reagent room, emergency specimen insertion, 24-hour standby status, supporting the Chinese software system, calibration solution, quality control substances, reagents, and domestic reagents can be applied on the machine, the price and performance ratio, the manufacturer's after-sales service, the strength of the agent's credibility and other aspects of the comparison. 2, field visits: through the comparison of the above information, the relevant instruments have a Rational understanding. Then go to the hospital with the same type of instrument for inspection, mainly to watch the object, ask about the use of the instrument, the performance of the instrument, problems and precautions. The selection of the instrument should also be combined with the setup of the clinical departments, the price of the instrument and whether to increase the additional burden on patients and other factors for comprehensive consideration. For example, the white blood cell classification result of blood cell counter is "primary screening" regardless of whether it is a triple group or a quintuple group, while the price of quintuple group blood cell counter is twice or even higher than that of triple group, and the cost of its consumable reagents is also much higher than that of triple group blood cell counter. Obviously, in the small and medium-sized hospitals without hematology specialties, it is more reasonable to choose the three groups of blood cell counters. Second, the management of the instrument after the installation of the instrument, good management, can give full play to its role in reducing the labor intensity of the test personnel, improve the efficiency and quality of testing for clinicians and patients to provide accurate and effective information. On the contrary, not only can not improve work efficiency, but also increase the trouble of the test personnel, and even mislead doctors and patients. How to manage the instruments and equipment, give full play to its role?1, personnel training: more than 50,000 yuan of imported instruments, many are high-tech products, large technical content, the operator level requirements are relatively high, and many instruments such as automatic biochemistry analyzer, blood counting machine, coagulation meter and electrochemiluminescence immunoassay analyzer are to do emergency testing, therefore, all the Department of Laboratory staff to participate in on-line operation of the training. Training. Training includes instrument manufacturers to the Department of training and internal organization of the Department of training. The content of the training includes the basic principles of the instrument, basic operation, precautions, routine maintenance and so on. Through the training and assessment before the use of the relevant instruments, can avoid the operator is not familiar with the instrument and downtime or can not be used properly and affect the work. 2, the instrument before the application of assessment: In addition to the information provided by the manufacturer, we also need to instrumentation for precision, accuracy, linear range, reference value assessment. Such as high, medium and low fixed-value serum to do intra-batch, day-to-day precision and accuracy determination, coagulation instrument to make the laboratory reference value as well as 20 copies of normal medical examiner plasma mixed to do the control test and repeatability of the test; instrumentation parameters shall not be modified without the consent of the section chief. The development of the operation of the instrument flow chart, so that the use of instruments standardized. 3, update the concept of service to the clinic: the development of medical testing to test medicine, the test personnel are required to not only operate a variety of instruments to obtain data, but also know some clinical knowledge, familiar with the clinical significance of the results of various measurements and the impact of interferences on the results of the test, the application of evidence-based test medicine methodology to provide effective information to the clinic. For example, after the introduction of instruments and equipment, the Department of Laboratory Medicine to the clinical departments to disseminate information to promote the instruments and equipment, including the basic principles, measurement items, clinical significance, reference range, the time of the report, the type of specimen and the amount of specimens, fees and so on. And cancel the original biochemical emergency investigation only sixteen items of regulations. All biochemical items done on the automatic biochemical analyzer, as long as the clinical requirements of urgent investigation, the Department of Laboratory Medicine is to do with the arrival. Coagulation meter on the PT, APTT, TT, Fbg and electrochemiluminescence meter on the HCG, TNT, Myo, CK-MB, etc. are listed as emergency items, with the arrival of do. For example, the earlier the diagnosis of acute myocardial infarction, the better, because thrombolytic therapy is optimal within 6 hours after infarction. In the past, clinicians used to use cardiac enzyme five (CK, CK-MB, LDH, HBDH, AST) to assist in the diagnosis, and its positive results appeared late, and the specificity is also poor. In contrast, the positive results of the three cardiac infarction items (Myo, TNT, CK-MB) of electrochemiluminescence instrument appeared 10 hours earlier than the five cardiac enzymes, and the specificity was higher. By doing experiments, to be acute myocardial infarction and stable angina pectoris patients infarction three and cardiac enzyme five results made of graphs provided to clinicians, and recommended that according to the length of time of chest pain appear to choose the appropriate items for testing, not only to help in the diagnosis and differential diagnosis, but also reduces the cost of the patient's examination. 4, to improve the use of the instrument, increase the economic benefits of the instrument: the laboratory can be daily routine biochemical specimens 50 or so, about 40 tests. In general, before 12:30 pm can be completed. General Laboratory will also have a larger physical examination tasks, physical examination tasks usually have time, and the hospital will not be in order to physical examination and then purchase a fully automated biochemical analyzer, if the department for this purpose and increase the number of test personnel, both to increase the cost of expenditures, but also will cause the usual situation of people floating in the matter. Therefore, to take a break not to rest the machine method, the physical examination period to increase a shift and a half night shift, the use of midday and evening time to do the physical examination surgery, to achieve the test results in the specified time to the hands of the examining doctor. 5, choose a high amount of reagents to ensure accurate and reliable results: the accuracy of the test results and the quality of the reagents. In general, the use of matching reagents and calibrators with the instrument to ensure accurate and reliable results. However, the original supporting reagents are very high prices, and the charges for each test are set by the Price Bureau, can not be changed arbitrarily, especially the biochemical program, each test charges 5 yuan / times, very few items for 10 yuan / times or 20 yuan / times. The biochemical reagents, calibrators and rinsing solutions used by the Laboratory are Beckman original reagents, which have a higher cost. According to the actual situation of the department, by doing parallel comparison reagents, high, medium and low value fixed value serum repetition test and Guangdong Province inter-office quality assessment activities for testing, it can be found that certain brands of reagents to test serum glucose, total protein, albumin, cholesterol, triglyceride, and other items are very good in terms of accuracy and precision, and they can completely replace the original supporting reagents, so as to make the cost lower. Through the experiment, the blood cell testing reagents have been completely localized. 6, instrument maintenance to implement: Although the laboratory personnel are trained to operate before the machine, skilled in the use of instruments, but due to the need for rotation, and to be on duty at night and go out for physical examination, there are often not on the shift. In view of the above situation, we according to the personnel specialties and relative stability and other factors, the maintenance of the instrument to the implementation of the implementation of a fixed person responsible for the greater maintenance of the instrument, under the guidance of the director of the Department of calibration of the instrument and quality control, to ensure that the instrument operates normally. In short, through the above management, reduce the staff's labor intensity, improve work efficiency, and more fully play the social and economic benefits of the instrument.