Department of Anesthesiology, Kasturba Medical College, Manipal, India.
Department of Anesthesiology, Lady Hardinge Medical College, New Delhi, India.
Korean J Anesthesiol. 2020 Jun;73(3):232-238. doi: 10.4097/kja.19402. Epub 2019 Dec 4.
Blood component mistransfusion is generally due to preventable clerical errors, specifically pretransfusion misidentification of patient/blood unit at bedside. Hence, electronic devices such as barcode scanners are recommended as the standard instrument used to check the patient's identity. However, several healthcare facilities in underdeveloped countries cannot afford this instrument; hence, they usually perform subjective visual assessment to check the patient's identity. This type of assessment is prone to clinical errors, which precipitates significant level of anxiety in the healthcare personnel transfusing the blood unit. Hence, a novel objective method in performing pretransfusion identity check, the 'Sandesh Positive-Negative (SPON) protocol,' was developed.
A nonrandomized study on bedside pretransfusion identity check was conducted, and 75 health care personnel performed transfusion. The intervention was performed by matching a custom-made negative label with blood component with the positive label of the same patient available at bedside who was about to receive transfusion.
In total, 85.3% of the subjects were anxious while performing pretransfusion identity check based on the existing standard practice. After the implementation of the SPON protocol, only 38.7% experienced either mild, moderate or severe anxiety. The overall level of satisfaction also increased from 8.0% to 38.7% and none were dissatisfied. Although only 9.3% were dissatisfied about the existing practice, approximately 70.7% felt the need for a better/additional protocol. Clerical error was not observed.
The SPON protocol is a cost-effective objective method that reduces anxiety and increases satisfaction levels when performing final bedside identity check of blood components.
血液成分输注错误通常是由于可预防的文书错误引起的，特别是在床边进行输血前患者/血液单位的身份识别错误。因此，建议使用条形码扫描器等电子设备作为核对患者身份的标准仪器。然而，一些欠发达国家的医疗机构无法承担这种仪器的费用；因此，他们通常进行主观的视觉评估来核对患者的身份。这种评估容易出现临床错误，导致输注血液单位的医护人员产生很大程度的焦虑。因此，开发了一种新的客观方法，即“桑德什正负（SPON）协议”，用于进行输血前的身份核对。
进行了一项非随机的床边输血前身份核对研究，共有 75 名医护人员进行了输血。干预措施是将定制的阴性标签与血液成分进行匹配，同时将同一即将接受输血的患者的阳性标签放在床边。
在基于现有标准实践进行输血前身份核对时，85.3%的受试者感到焦虑。实施 SPON 协议后，只有 38.7%的受试者感到轻度、中度或重度焦虑。总体满意度也从 8.0%增加到 38.7%，且无人不满意。尽管只有 9.3%的人对现有做法不满意，但约 70.7%的人认为需要更好/额外的协议。没有观察到文书错误。
SPON 协议是一种具有成本效益的客观方法，可降低焦虑程度并提高床边血液成分最终身份核对的满意度。
