Redesign of a Transfusion Issue Form Using Human Factors Science

Abstract

Blood transfusions are common procedures but are high risk for patient safety. Verification of the correct blood unit for the patient, assessments of the patient for symptoms of transfusion reactions, and quick responses to suspected reactions are the main interventions to ensure this process are safe. Each of these steps is aided by the transfusion issue form. We identified opportunities to use human factors principles to redesign and evaluate the form. We provide a discussion of the specific design changes and methods to facilitate use in other contexts.