University of California San Diego Health, La Jolla, California, USA.
Johns Hopkins University School of Medicine Baltimore, Baltimore, Maryland, USA.
Transfusion. 2023 Oct;63(10):1789-1796. doi: 10.1111/trf.17530. Epub 2023 Sep 3.
Collecting a patient's blood in a correctly labeled pretransfusion specimen tube is essential for accurate ABO typing and safe transfusion. Noncompliance with specimen collection procedures can lead to wrong blood in tube (WBIT) incidents with potentially fatal consequences. Recent WBIT events inspired the investigation of how various institutions currently reduce the risk of these errors and ensure accurate ABO typing of patient samples.
This article describes the techniques employed at various institutions across the United States to mitigate the risk of misidentified pretransfusion patient specimens. Details and considerations for each of these measures are provided.
Several institutions require the order for an ABO confirmation specimen, if indicated, to be generated from the transfusion medicine (TM) laboratory. Others issue a dedicated collection tube that is available exclusively from the TM service. Many institutions employ barcoding for electronic positive patient identification. Some use a combination of these strategies, depending on the locations or service lines from which the specimens are collected.
The description of various WBIT mitigation strategies will inform TM services on practices that may be effective at their respective institutions. Irrespective of the method(s) utilized, institutions should continue to monitor and mitigate specimen misidentification errors to promote sustained safe transfusion practices.
正确标记输血前标本管中的患者血液对于准确的 ABO 定型和安全输血至关重要。标本采集程序不符合规定可能导致潜在致命后果的血错管(WBIT)事件。最近的 WBIT 事件促使人们调查美国各机构目前如何降低这些错误的风险并确保患者样本的 ABO 定型准确。
本文介绍了美国各机构采用的技术,以降低误识别输血前患者标本的风险。提供了这些措施中的每一项的详细信息和注意事项。
一些机构要求如果需要,则从输血医学(TM)实验室生成 ABO 确认标本的医嘱。其他机构则提供专门的采集管,仅可从 TM 服务获得。许多机构采用条形码进行电子阳性患者识别。一些机构根据标本采集的地点或服务线,结合使用这些策略。
对各种 WBIT 缓解策略的描述将为 TM 服务提供有关其各自机构可能有效的实践信息。无论使用哪种方法,机构都应继续监测和缓解标本识别错误,以促进持续的安全输血实践。