Since the beginning of the 20th century when the first tests for blood compatibility were performed, there have been many important developments in the transfusion area. Probably one of the most significant is related to advances in technology.AIMS
We want to analyse the impact of the electronic management of transfusion on errors reported in our Haemovigilance program.MATERIALS AND METHODS
Transfusion procedures at our hospital included: Patient identification with a hand badge carrying a transfusion security code before sample collection, registration of samples in a transfusion software, component selection, automatic compatibility tests, and checking blood component label and patient hand badge before transfusion at bedside. The Blood Bank Software, implemented since 1996 to the present, in web technology (e-Delphyn - Hemasoft Company), permits the electronic cross match, establishs conditions for blood components liberation (Irradiation, etc), connection in bidirectional way with autoanalysers and other devices for electronic control of all transfusion steps. Events in any phase of transfusion procedure during the period from 2000 to 2015 were reviewed from our Haemovigilance database and classified in errors in blood component administration (BAE) and events that was detected before administration (NME).RESULTS
Between 2000 and 2015 a total of 727.301 blood components were transfused. Of them, 469.255 corresponded to red blood cell concentrates. Overall, 162 events were detected in blood component administration (BAE) and 437 episodes of near miss event (NME) but in some episodes more than one error occurred. Finally 506 errors were detected before transfusion and 176 finished in EAC resulting in a prevalence of 1 in 1066 blood components administrated. Regarding the causes of NME, the mistakes were most commonly seen during component prescription (41%), sample collection (28%) and sample registration (16%). The incorrect use of patient’s identification pre-printed adhesive labels was the commonest reason for error. Other NME were 2% in selection phase, 7% in compatibility testing and 4% en transfusion procedures at bedside. By contrast, the BAE more common occurred in prescription phase (25%), selection of blood components (38%) and transfusion (29%), due to use pre-printed adhesive labels for patient identification, use of blood components without irradiation and miss identification at bedside respectively. The other errors were minor and corresponded to sample extraction (1%), registries (2%) and compatibility testing (4%)CONCLUSIONS
A significant number of mistakes can occur during the transfusion procedure. In our experience, the BAE due to errors in compatibility testing, sample extraction and registries are infrequent, suggesting that the use of a specific hand badge, analytical test automation and electronic management of transfusions is effective to reduce the errors. The most frequent errors were detected in those phases of transfusion in which electronic control was not implemented. In our opinion, most errors due to the use of adhesive pre-printed labels and identification of patient before transfusion could be avoid by electronic prescriptions and electronic check at bedside.
In a bid to improve blood transfusion services in the country, Tanzania National Blood Transfusion Services (NBTS) has launched Blood Establishment Computer System (BECS) to help track blood transfusion services from the donor anywhere in the country.
The system will among other things keep the data base of donors and automatically send a text message to those eligible for next donation.
BECS was launched by the first lady Mama Salma Kikwete in Kigoma last week at the climax of World Blood Donor Day (WBDD) which was hosted by Kigoma Region.
According to NBTS Information Combination and Technology (ICT) officer George Mpopo, the system will help eliminate human errors in blood transfusion services and hence improve the efficiency of blood transfusions.
Speaking to the Guardian recently at the Evidence for Action Offices (E4A) in Dar es Salaam, Mpopo said, the system which now replaces the old manual system will help NBTS manage blood donor information, collection, testing, processing, and storage, distribution of blood to hospitals and transfusion of the collected blood.
´BECS will be able to track blood from the vein of the donor to the vein of the recipient,´ Mpopo said pointing out that, ´...that is why it is also referred to as the vein to vein system.´
He said besides recalling donors for the next donation, BECS will also help NBTS identify safe blood donor pools, to be invited for next donation.
´The system is also capable of rejecting unsafe blood donors,´ he said.
´BECS will create a data base of people donating blood and their blood status, so if someone is found to have transfusion transmissible infections their blood will automatically be red flagged,´ he detailed.
In the past, before BECS system, NBTS relied on manual paper work in record keeping of the donor, analysis, storage and distribution of blood and blood products but now the system will also help NBTS counselors educate those found with HIV or Hepatitis B and C negative.
´Improving awareness of risk behaviours among blood donors will help reduce the number of new infections among the would be and current blood donors,´ Mpopo said.
E4A country director craig John Ferla lauded NBTS for launching BECS saying blood safety is paramount importance given growing concerns of blood safety with respect to transfusion transmissible infections like HIV, hepatitis B and C and syphilis.
´What is also good is that with BECS in place NBTS now can recall only those with safe blood for a next donation when they are due, and hence save resources and ensure that the blood collected isn´t thrown due to transfusion of transmissible infections´, Craig said.
Notably, the establishment of BECS by NBTS Tanzania has been facilitated by funding support from Association of American Blood Bank (AABB).
Informatization along with effective National Blood Transfusion Service (NBTS) is a precondition for quality and safe transfusion therapy. After the Croatian War of Independence ended in 1995, we recognized the necessity of establishing such a transfusion service in our country.
This paper describes the activities taken in the past 18 years in order to accomplish our professional vision, i.e. to establish the Croatian National Blood Transfusion Service (NBTS) with the National Blood IT (Information Technology) Transfusion System implemented. Our intention was to create national consistency in order to improve blood donor and patient care and safety, and to provide the environment in which blood donor and patient centered information can be safe, but easily and quickly shared.
NBTS RESTRUCTURING PROJECT - 3 consolidation phases:
NBTS INFORMATIZATION PROJECT:
Restructuring and informatization of the Croatian NBTS are permanent activities due to the expected future stringent standards for blood collection and processing and transfusion therapy. The forthcoming is: progressive merging of BE, National Blood Policy, National Coordinated Quality System; e-Delphyn IT system: further development and upgrades, connection of the remaining HBB into IT system. Croatia could be the first country in the world with all the BE and HBB centers connected in one National Blood Transfusion IT System.
Hemasoft is proud to announce the final successful stage of the National deployment of e-Delphyn throughout Croatia.
Croatia finalized the implementation of e-Delphyn in all regions and Hospital networks of Croatia, joining the growing number of countries deploying e-Delphyn Nationwide.
Dr. Jukick quoted: ´Deploying the web-enabled solution e-Delphyn on a Nationwide basis was a challenge for us, but thanks to the professionalism and expertise of Hemasoft people and their local partners, we have now, at the time of joining the Euro zone, one of the most sophisticated IT systems controlling the national Croatian blood supply. I would personally recommend to all European Blood organizations to look at our IT solutions which is based on the latest technologies and provides our National Institute with a cost-efficient national backbone.´
Bruno Rousselin, VP of Global Business Development, commented: ´Hemasoft is currently implementing its solutions in other regional and national deployments. The acquired experience with Croatia is clearly positioning Hemasoft as one of the main IT solutions provides for Transfusion Medicine in Europe´.
Hemasoft is proud to announce that Hemomadrid, specialized company offering Hematology and Hemotherapy services, has installed e-Delphyn Transfusion Software in a centralized Housing environment comprising more than 10 hospitals and health centers.
It's always nite to receive this type of comments from our customers, especially when they can establish a fair comparison of our products and services with other vendors. Hemasoft has now a long track record of successfully migrating other systems to e-Delphyn. We will soon post other success stories of recent migrations.
"The beauty of change is with us as we have waved goodbyes to the Progress System and open our hands wide open for the
e-Delphyn System. The e-Delphyn System from Hemasoft. The e-Delphyn System came as an advantage to a greater extent. It subtracted longer processes we used to experience so as to reach the destination using the Progress System. Things like bulk take-off, separation of panel bleed donor printouts, printing on the noisy and slow dot matrix printer, need for the supervisor´s pass word every time one need to view donor pack numbers and correcting errors, the hustle of always approaching the I.T crew to merge donations for us to
list but a few. The e-Delphyn System has a marvelous tracking system that one is able to view/track the work done at the end
of the day. Some of the information that can be tracked/viewed is the time the donor form was captured, the personnel who
captured the information, donation type, bag type, gender and it is very possible to view work done in other Branches.
This system has taken away the hustle of waiting for scheduled panels to be emailed by the Blood procurement Department, what need to be done is us to search for the booked and scheduled panels in the e-Delphyn System. Another advantage is easy compilation of monthly statistics for our section´s progress report. However like every newly born baby it will be a recorded miracle if the baby does not come with negatives and challenges. We experienced or rather still experiencing (putting slow learners in mind) changing of terms e.g. from pack number to donation number and from regular donor to eligible donor. The capturing process for e-Delphyn System is a bit longer as compared to progress system. There are also additions of mandatory data required to be filled in when capturing a donor form such as the authorizer, phlebotomist, bag type, province/state, and donor´s means of recruitment, donation type, status and session. Despite the difficult time we are going though in accepting the change, we tasked ourselves to thoroughly understand the e-Delphyn System. On a user´s perspective I can safely rate the new system as a positive change and positively we are working towards fully adapting and learning the e-Delphyn System concepts through to its roots.´
Since May 2013, Centro Estatal de Transfusión Sanguínea de Veracruz (México) has been Live with the e-Delphyn BB solution. In the coming weeks, eight additional centers in Veracruz State will join the project, managing blood donations and transfusion activities in a centralized environment.
Hemasoft Software proudly announces the new multi-site e-Delphyn BB installation centralizing blood donations and transfusion services in Santiago de Chile Blood Center and seven associated hospitals.
Hemasoft expands its presence in South America signing a contract with the Instituto Metropolitano de Sangre y Tejidos in Santiago, Chile.
Pedro Pereda, CEO of Hemasoft quoted "We are proud to bring our e-Delphyn® technology to one of the most prestigious establishments in South America. Hemasoft will deploy e-Delphyn® Blood and Tissues modules to the main Blood Center while connecting a network of 9 Hospitals to the main Blood Center through our Web-enabled solutions.
Our partner in Australia, ALSG has finalized the agreement with King Edwards Memorial Hospital in Perth,
Australia to deploy e-Delphyn® Human Milk Bank solution.
Bruno Rousselin, VP of International Sales and Business Development commented "Hemasoft is signing its first contract in Australia thanks to its fruitful partnership with ALSG. Prof. Ben Hartman, recognized worldwide as an expert in Human Milk Banking has decided to deploy e-Delphyn and use the Donor, Manufacturing and Hospital traceability capabilities at Kind Edwards. We are optimistic this contract will lead the way to more deployments of e-Delphyn in the region soon".
Our customers at the Blood Center of Concepcion, Chile is now live with e-Delphyn® Transfusion with more than 17 hospitals connected.
Pedro Pereda, CEO of Hemasoft commented "We are very happy to see more sites in Chile joining the long list of South American customers using e-Delphyn® Transfusion. This deployment reflects the multi-site capabilities of e-Delphyn and how Hemasoft can provide a Donor-to-Recipient solution connecting the Blood Center to its Hospital users".
Hemasoft is proud to announce the current deployment of its e-Delphyn LIS solution at one of the largest and most prestigious hospital in the Middle East region: King Hamad University Hospital in Bahrain.
Hemasoft is proud to announce that NYUMC will soon use its e-Delphyn® Cell Therapy Solution.
Bruno Rousselin, VP of International Sales & Business Development quoted "Providing our solution to a worldwide renowned establishment like New York University Medical Center is a major accomplishment for Hemasoft. Our company is helping hundred of customers worldwide to ensure the safety of their processes every day by using our solutions. We are proud that NYUMC is now joining the list of our prestigious customers...".