1277 / Implementing safe transfusions through a smart RFID system

SPAIN
Classification of the PSP
Type of Patient Safety Practice Safe
 
Clinical Practice (CP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Blood / Blood products
Patient identification There is no specified text here
Topic of the reported practice
Patient safety system
Aim and the benefit of the Patient Safety Practice
 
A significant problem in blood transfusion is the incorrect blood administration due to miss identification in any step of the process. Efforts must be done to avoid human errors in the key points: identification of correct patient, pre-transfuion sample and correct blood component at bed-side transfusion.
Description of the Patient Safety Practice
 
Transfusion Safety Systems Hospital hemovigilance networks show as a significant risk of transfusion the inadequate identification of the recipient and blood unit. Although there are systems to prevent the occurrence of this error, all have limitations. The ideal system should be easy to implement, easy to use and affordable for the hospital budget. Our RFID (radio-frequency identification) system reduces this risk in an effective way, offering a high degree of safety and less chance for human error when crossmatching and administering transfusions. It is very easy to use, quickly implemented, requires minimal staff training, and is highly cost effective. Finally, it offers excellent data traceability, it is very adaptable, and has a high capacity of integration with hospital systems and technologies. The system consists of three basic elements 1. Patient bracelet RFID radiofrequency identification ? Bracelet MIXED: Tag RFID, barcode and space to write the patient identification. 2. RFID container security for the blood component ? Physical locking unit which includes electronic processor and memory where data are recorded ? The RFID container is unlocked only in the presence of the appropriate patient when matched with the corresponding bracelet. ? Registers total transfusion traceability ? Compatible with the distribution systems of pneumatic tubes. 3. Charging station for containers, personal computer and software ? Battery charging station ? Control the inventory of containers and their status ? Allows the programming of the RFID electronic with the information of the blood bag that it contains via USB. Five steps are necessary for a safe transfusion 1. Placing the RFID bracelet to the patient and pretransfusional sample collection. ? Identification of the pretransfusional sample with barcode labels ? Sending samples and transfusional orders to the Transfusion Service. 2. Pre transfusion testing laboratory ? Register of all data relative to the transfusional orders and samples to the informatic system of the Transfusion Service. ? Pre-transfusion testing and selection of the compatible component. ? Component labeling (label compatibility) with the Transfusion Security Number (TSN) 3. Preparation and distribution of blood component ? The blood component is entered and locked into the Container Security ? The information from the tag is read and recorded to the container via USB. 4. Transfusional act at bedside ? The Container Security must be approached to the patient's wristband ? If it is the right patient, the container is unlocked and blood components are removed to start transfusion 5. The return of the container to the Transfusion Service. In this way, the transfusion cycle is closed, ensuring the traceability and the correct identification of the receptor and product. Implementation of the system The RFID barrier system was implemented at the Hospital de la Santa Creu i Sant Pau located in Barcelona in 2013. It is the only tertiary and teaching hospital (630 beds) in Spain that has adopted this system in all its wards. First, a study of all the transfusion safety systems available in the market was made. Finally we chose the unique system available with containers using RFID barrier technology. For a successful implementation of this transfusion safety system it was essential an active involvement of all medical and nursing staff related to transfusion. A committee of the hospital was created with caregivers and representatives from the Transfusion Service, and a training plan was developed for all wards, with theoretical and practical sessions. A sequential implementation plan for the system training and a basic manual operator with graphic images was developed for diffusion. In an initial phase, the use of this new system began at the day hospital of the service of oncohematology, the ICU and at the inpatient unit of clinical hematology. It started in October 2013 and until December 2013 657 transfusions were performed with this system. In a second stage, after the successful results of the first phase, and after analyzing the possible logistical problems that arose in the first phase, it was decided to extend the security system around all the hospital (including the operating rooms and the central ED). Exception was the pediatric ward due to peculiarities of patients. This second phase began in March 2014 and it is still ongoing.
Attachment of relevant written information and/or photos, as appropriate
2015113006200328721_WP4_Veridentia_01.pdf
There is no specified text here
There is no specified text here
There is no specified text here
Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, fully
Level of implementation of reported practice
Institution level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
Yes
A measurement after full implementation of the reported practice was obtained
Yes
Evaluation of a "positive" effect of the reported practice on Patient Safety
The evaluation showed improvements in Patient Safety outcomes
Type of before-and after evaluation
Quantitative
Enclosure of a reference or attachment in case of published evaluation's results
No publications.
There is no specified text here
Health care context where the Patient Safety Practices was implemented
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
No
Specification of implementation in another health care setting(s)
There is no specified text here
Successful implementation's level  of this Patient Safety Practice across settings
There is no specified text here
Involved health care staff
 
Physicians
Nurses
Technical support / technician
Clinical manager
Quality manager
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
No
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
There is no specified text here
Point of time in which service user or their reprasentatives' involvement takes place
There is no specified text here
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
There is no specified text here
Short description of the service users' level of involvement
There is no specified text here
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
No
List of sources where public information is accessible
There is no specified text here
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
Yes
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
Lack of sharing of progress information among involved staff
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
There is no specified text here
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
No
Description of used incentives, if any.
There is no specified text here
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
Yes
Total number of person days required to implement this Patient Safety Practice
Clinical staff: 4
External consultants: 15
Support staff: 3
Managerial staff: 0
Others: 0
Not relevant: 0
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: 25
External consultants: 0
Support staff: 3
Managerial staff: 0
Others: 0
Not relevant: 0
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
20000
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
0
Contact information
 
Name: Alba Bosch
Country: SPAIN
Organisation: Banc de Sang i Teixits H Sant Pau
E-mail: abosch@bst.cat
Phone: +34935537591
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