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71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

Introduction of a novel mobile electronic bar code-based documentation of blood component transfusions – a prospective pilot study

Barcode-unterstützte Dokumentation von Bluttransfusionen mittels mobilem Device – prospektive Pilotstudie

Meeting Abstract

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  • presenting/speaker Jasmin E. Scorzin - Universitätsklinikum Bonn, Klinik für Neurochirurgie, Bonn, Deutschland
  • Mohammed Banat - Universitätsklinikum Bonn, Klinik für Neurochirurgie, Bonn, Deutschland
  • Hartmut Vatter - Universitätsklinikum Bonn, Klinik für Neurochirurgie, Bonn, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocP077

doi: 10.3205/20dgnc364, urn:nbn:de:0183-20dgnc3647

Published: June 26, 2020

© 2020 Scorzin et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

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Objective: Ever since the introduction of electronic patient charts, documentation of blood product transfusions remains a manual process on paper, in most clinics. National guidelines require detailed documentation according to the German Transfusion Act. A number of studies revealed that manual pretransfusion check and documentation on paper is inappropriate in daily transfusion medicine practice. Misidentification of patient and mismatch to the blood product are the most frequent factors for transfusion errors. We introduced an electronic documentation process and have conducted a pilot study to examine the accuracy and compliance in daily blood transfusion process in our clinic since 4/2019.

Methods: Patients were allocated an ID wristband at admission to our clinic by standard. The blood product and the accompanying note were labelled with bar codes which provided the transfusion relevant information. The bar code scanning, pre- and posttransfusion check and signed documentation was performed bedside via a mobile device (iPad) App by the transfusion practitioner. The App provides several plausibility notifications if incompatibility between patient’s ID, crossmatched blood parameters and the blood product occurs. The data was directly transferred to the patient´s electronic medical chart (ORBIS, AGFA HealthCare) via the hospital WLAN. Close audits were provided according to PDCA quality improvement cycle.

Results: 103 blood component units (13 FFP, 22 TC, 68 PRC) were transfused between April and November 2019. A total of 55 (53.4%) inaccurate or incomplete electronic documentations were observed through the audits. After re-training of the staff members, the rate of incorrect documentation dropped from 66.1% in the first 4 months to 34.1% in the 3 months after the re-training. In total an incomplete documentation was counted in 33 cases (32.0%), missing Rh-group documentation was observed in 14.6%, inappropriate documentation of transfusion time occurred in 9.7% and incorrect ABO-/Rh-group was entered in 5.8%. In 5 transfusion cases, electronic documentation could not be achieved because of malfunction of the mobile devices.

Conclusion: Electronic bar code-based documentation has been reported to be beneficial in reducing blood administration errors. The presented process was not as robust as expected. However, regular audits and periodical re-training of the practitioners have proven to be crucial and efficacious.