Dusseljee-Peute Linda W, Van der Togt Remko, Jansen Bas, Jaspers Monique W
Academic Medical Center- Amsterdam, Department of Medical Informatics, University of Amsterdam, Amsterdam, Netherlands.
JMIR Med Inform. 2019 Aug 5;7(3):e9510. doi: 10.2196/medinform.9510.
A complex process like the blood transfusion chain could benefit from modern technologies such as radio frequency identification (RFID). RFID could, for example, play an important role in generating logistic and temperature data of blood products, which are important in assessing the quality of the logistic process of blood transfusions and the product itself.
This study aimed to evaluate whether location, time stamp, and temperature data generated in real time by an active RFID system containing temperature sensors attached to red blood cell (RBC) products can be used to assess the compliance of the management of RBCs to 4 intrahospital European and Dutch guidelines prescribing logistic and temperature constraints in an academic hospital setting.
An RFID infrastructure supported the tracking and tracing of 243 tagged RBCs in a clinical setting inside the hospital at the blood transfusion laboratory, the operating room complex, and the intensive care unit within the Academic Medical Center, a large academic hospital in Amsterdam, the Netherlands. The compliance of the management of 182 out of the 243 tagged RBCs could be assessed on their adherence to the following guidelines on intrahospital storage, transport, and distribution: (1) RBCs must be preserved within an environment with a temperature between 2°C and 6°C; (2) RBCs have to be transfused within 1 hour after they have left a validated cooling system; (3) RBCs that have reached a temperature above 10°C must not be restored or must be transfused within 24 hours or else be destroyed; (4) unused RBCs are to be returned to the BTL within 24 hours after they left the transfusion laboratory.
In total, 4 blood products (4/182 compliant; 2.2%) complied to all applicable guidelines. Moreover, 15 blood products (15/182 not compliant to 1 out of several guidelines; 8.2%) were not compliant to one of the guidelines of either 2 or 3 relevant guidelines. Finally, 148 blood products (148/182 not compliant to 2 guidelines; 81.3%) were not compliant to 2 out of the 3 relevant guidelines.
The results point out the possibilities of using RFID technology to assess the quality of the blood transfusion chain itself inside a hospital setting in reference to intrahospital guidelines concerning the storage, transport, and distribution conditions of RBCs. This study shows the potentials of RFID in identifying potential bottlenecks in hospital organizations' processes by use of objective data, which are to be tackled in process redesign efforts. The effect of these efforts can subsequently be evaluated by the use of RFID again. As such, RFID can play a significant role in optimization of the quality of the blood transfusion chain.
像输血链这样的复杂过程可以从诸如射频识别（RFID）等现代技术中受益。例如，RFID在生成血液制品的物流和温度数据方面可以发挥重要作用，这些数据对于评估输血物流过程和产品本身的质量很重要。
本研究旨在评估一个有源RFID系统（该系统包含附着在红细胞（RBC）制品上的温度传感器）实时生成的位置、时间戳和温度数据，是否可用于评估在学术医院环境中红细胞管理对4项欧洲和荷兰医院内部指南（规定了物流和温度限制）的合规情况。
在荷兰阿姆斯特丹一家大型学术医院——学术医学中心内的输血实验室、手术室综合区和重症监护病房等医院临床环境中，一个RFID基础设施支持对243个贴有标签的红细胞进行追踪和溯源。可以根据182个贴有标签的红细胞对以下医院内部储存、运输和分发指南的遵守情况来评估其管理的合规性：（1）红细胞必须保存在温度为2°C至6°C的环境中；（2）红细胞离开经过验证的冷却系统后必须在1小时内输注；（3）温度超过10°C的红细胞不得恢复使用，或必须在24小时内输注，否则予以销毁；（4）未使用的红细胞在离开输血实验室后24小时内必须返回输血实验室。
总共有4个血液制品（4/182符合要求；2.2%）符合所有适用指南。此外，15个血液制品（15/182不符合若干指南中的1项；8.2%）不符合2项或3项相关指南中的1项。最后，148个血液制品（148/182不符合2项指南；81.3%）不符合3项相关指南中的2项。
结果指出了利用RFID技术根据医院内部关于红细胞储存、运输和分发条件的指南来评估医院环境中输血链本身质量的可能性。本研究表明，RFID有潜力通过使用客观数据识别医院组织流程中的潜在瓶颈，这些瓶颈需要在流程重新设计工作中加以解决。随后可以再次使用RFID来评估这些努力的效果。因此，RFID在优化输血链质量方面可以发挥重要作用。
