Manage Your Resources: Pearls and Pitfalls of Transfusion Medicine Informatics Solutions

2018 AABB Annual Meeting Session

Program Chair: Nabiha Saifee, MD, PhD
Speakers: Ronald Jackups, MD, PhD; Kristina Guido, MT (ASCP)CM; Dee Townsend-McCall, RN, BSN; Nabiha Saifee, MD, PhD
Intended Audience: Nurse, Medical Director, Manager, Director, COO, CEO, Perfusionist, Physician, Residents/Fellow, Student (MD, MT, SBB), Supervisor, Technologist, Transfusion Safety Officer
Teaching Level: Basic

Learning Objectives:

• Recognize potential error-prone workarounds that may be used after implementation of barcoded patient positive identification systems
• Explain IT-based solutions to prevent inappropriate blood product selection
• Examine gaps in manual and IT-based processes for ABO selection of products for patients who have received ABO-incompatible hematopoietic stem cell or solid organ transplants

Description: A multidisciplinary group of presenters, including transfusion service medical directors, a supervisor, and a nurse consultant, will discuss IT-based solutions for transfusion medicine practice, with focus on the benefits and possible pitfalls. Technologies to be discussed include positive patient identification (PPID) for sample collection and blood administration, compatibility tables for patients receiving ABO-incompatible transplants, and blood orders including transfusion attributes. Bar-code based PPID systems offer the promise of eliminating wrong blood in-tube (WBIT) and mis-transfusion, but transfusion services should also be aware of the error-prone workarounds that may still be used by care teams. Most hospitals utilize electronic crossmatch (computer-based compatibility testing) for the majority of patients, but traditional compatibility tables do not control ABO selection of products for patients receiving ABO-incompatible solid organ or hematopoietic stem cell transplants. Here, we present novel ABO compatibility tables that hardwire selection of red blood cell and plasma-containing products based on donor and recipient ABO types. Finally, we will demonstrate an example of a customized view of transfusion-related patient information that includes status of in-date type and screen and confirmatory specimens, a modifiable transfusion profile, ABO compatibility for patients with transplants, relevant lab results, transfusion service notes, and transfusion history. The customized page for patient transfusion data can be used to not only notify the transfusion service of required attributes for transfusion, but can also be used by nurses and providers administering blood products to check patient transfusion requirements and ABO selection prior to blood administration.