Ohsaka Akimichi, Abe Katsumi, Ohsawa Toshiya, Miyake Noriko, Sugita Shio, Tojima Ikuko
Department of Transfusion Medicine and Stem Cell Regulation, Juntendo University School of Medicine, Tokyo, Japan.
Transfusion. 2008 Aug;48(8):1730-8. doi: 10.1111/j.1537-2995.2008.01744.x. Epub 2008 May 14.
ABO-incompatible blood transfusions attributable to inadequate identification (ID) of the patient or the blood unit are among the most serious of transfusion hazards. It has been unclear whether a computer-assisted transfusion management system connected to a bar code ID system could contribute to the appropriate management of blood components, as well as to the prevention of mistransfusions.
A transfusion management system has been developed that links the hospital information system, a bar code patient-blood unit ID system, and an automated device for pretransfusion testing. The guidelines for issuing blood components from the transfusion service were also changed. The appropriateness of blood management was evaluated by monitoring the time to initiate transfusion after issuing a blood unit from the transfusion service (time after issuing [TAI]) and by calculating the number of units issued and subsequently returned, as well as the rate of date-expired red cell (RBC) components.
From July 2002 to December 2006, a total of 49,974 blood components were transfused without a single mistransfusion. The monitoring of TAI and the notice to use the issued blood immediately had the effect of shortening TAI in the inpatient ward. The number of issued and subsequently returned RBC components, as well as the rate of date-expired RBC components, decreased significantly after the introduction of the system.
A computer-assisted transfusion management system and changing transfusion practices appear useful in preventing mistransfusions and in contributing to the appropriate management of blood components.
因患者或血袋识别不足导致的ABO血型不相容输血是最严重的输血风险之一。目前尚不清楚连接条形码识别系统的计算机辅助输血管理系统是否有助于血液成分的合理管理以及预防输血错误。
开发了一种输血管理系统,该系统将医院信息系统、条形码患者-血袋识别系统以及输血前检测自动化设备连接起来。输血服务部门发放血液成分的指南也进行了修改。通过监测从输血服务部门发放血袋后开始输血的时间(发放后时间[TAI]),计算发放和随后退回的血袋数量以及过期红细胞(RBC)成分的比例,来评估血液管理的合理性。
2002年7月至2006年12月,共输注了49974个血液成分,无一例输血错误。对TAI的监测以及立即使用已发放血液的通知,缩短了住院病房的TAI。引入该系统后,发放并随后退回的RBC成分数量以及过期RBC成分的比例显著下降。
计算机辅助输血管理系统和改变输血操作在预防输血错误以及有助于血液成分的合理管理方面似乎是有用的。