Laboratory Haematology Department, The Alfred Hospital, Melbourne, Victoria, Australia.
Vox Sang. 2013 Aug;105(2):159-66. doi: 10.1111/vox.12034. Epub 2013 Apr 19.
Errors in administration of blood products can lead to poor patient outcomes including fatal ABO incompatible transfusions. This pilot study sought to establish whether the use of two-dimensional (2D) barcode technology combined with patient identification software designed to assist in blood administration improves the bedside administration of transfusions in an Australian tertiary hospital.
The study was conducted in a Haematology/Oncology Day Clinic of a major metropolitan hospital, to evaluate the use of 2D barcode technology and patient safety-software and hand-held PDAs to assist nursing staff in patient identification and blood administration. Comparative audits were conducted before and after the technology's implementation.
The preimplementation transfusion practice audits demonstrated a poor understanding of the blood checking process, with focus on the product rather than patient identification. Following the implementation of 2D barcode technology and patient safety-software, there was significant improvement in administration practice. Positive, verbal patient identification improved from 57% (51/90) to 94% (75/80). Similarly, the cross-referencing of the patient's identification with the patient's wristband improved from 36% (32/90) to 94% (75/80), and the cross-referencing of patient ID on the compatibility tag to wristbands improved from 48% (43/90) to 99% (79/80). Importantly, the 2D barcode technology and patient safety-software saw 100% (80/80) of checks being conducted at the patient bedside, compared with 76% (68/90) in the preimplementation audits.
This pilot study demonstrates that 2D barcode technology and patient safety-software significantly improves the bedside check of patient and blood product identification in an Australian setting.
血液制品给药错误可导致不良的患者结局,包括致命的 ABO 不相容输血。本试点研究旨在确定二维(2D)条码技术与旨在协助输血给药的患者识别软件的联合使用是否可改善澳大利亚一家三级医院的床边输血给药。
该研究在一家大型都市医院的血液科/肿瘤学日间诊所进行,旨在评估 2D 条码技术和患者安全软件与手持 PDA 的联合使用,以协助护理人员进行患者识别和血液给药。在技术实施前后进行了比较性审核。
在技术实施前的输血实践审核中,对血液检查过程的理解较差,重点是产品而不是患者识别。在实施 2D 条码技术和患者安全软件后,给药实践得到了显著改善。阳性、口头患者识别从 57%(51/90)提高到 94%(75/80)。同样,患者识别与患者腕带的交叉核对从 36%(32/90)提高到 94%(75/80),患者 ID 与相容性标签到腕带的交叉核对从 48%(43/90)提高到 99%(79/80)。重要的是,2D 条码技术和患者安全软件实现了 100%(80/80)的床边检查,而在实施前的审核中,这一比例为 76%(68/90)。
本试点研究表明,2D 条码技术和患者安全软件可显著改善澳大利亚环境下的患者和血液产品识别的床边检查。