How to improve blood transfusion safety through information technology and practices

Background/objectives

The essence of safe blood transfusion is providing the right blood to the right patient at the right time. To improve transfusion safety, we implemented a suite of information technologies across the entire process to standardize clinical practices.

Methods

Our approaches include automatic warnings in storage management, regulatory restrictions and adaptive alerts in transfusion request, cross-checking in blood issuance, barcode matching for patient identification, personal digital assistants tracking throughout transfusion processes, spontaneous reminders for adverse actions, information sharing for individualized transfusion, and system overrides for special situations. The system generated data were analyzed using Excel.

Results

Data from 2019 to 2024 indicate a waste rate of 1.0 %. The average turnaround time for blood issuance ranged from 71.4 to 173.5 min. The percentage of transfusions starting beyond 30 min and completing beyond 4 h fluctuated over the six-year period. For red blood cells, these percentages gradually decreased to 2.8 % and 0.7 %, respectively. The overall transfusion reaction rate per 100,000 units was 746.9. A total of 1165 red cell requests exceeded the threshold, with 119 lacking reasonable justification. Additionally, two near-miss events are presented.

Conclusion

Integrating regulatory limitations and reminders into a transfusion knowledge base prevents knowledge errors. Technical identification and alert systems are effective in reducing slip errors. Information technology enhances transfusion safety by improving adherence to transfusion guidelines and minimizing avoidable operational errors.