Background/Case Studies: Finding experienced Medical Laboratory Scientists (MLS) is often difficult. With new graduates or any less experienced MLS comes their challenges, especially in critical care departments like transfusion medicine. Ensuring compatibility during transfusions is vital to mitigate complications associated with delayed transfusion reactions. Manual hemagglutination antigen typing (TUBE) plays a crucial role in the blood banking process but is susceptible to potential human error, particularly by those with less expertise. Often blood banks have implemented automated analyzers to assist with this issue. This study was aimed at evaluating reliable results involving antigen typing conducted by students compared to MLS with more expertise.
Study
Design/Methods: The study sought to evaluate the acceptable results obtained by students in an MLS program, who were newly acquainted with the procedure to antigen-type samples and those more experienced MLS (5-16 years) from the nearby hospital. This study was a single-blind approach for two months. Each student would allocate different panel cells into different tubes and assign them to a student or MLS. Each participant would perform TUBE testing for the following antigens: Fya, Fyb, Jka, Jkb, S, K, D, C, E, c, and e on random samples. Participants received 5 different unidentified samples and adhered to the procedures established by their respective programs or institutions.
Results/Findings: Results showed an average of 90% acceptable results. Although average results were higher than 75% in accuracy, there was a constant higher percent of human error for new students when performing antigen typing, especially when performing multiple antigen types at one time. Those errors lead to more time spent performing antigen typing with more materials and labor wasted. An unexpected error occurred during K antigen typing by MLS with 5 years of experience. This error resulted in only a 67% acceptable rate based on the number of antigens performed at that time.
Conclusions: Transfusion services often are short-staffed and appreciate the opportunity to hire new MLS graduates. There are many advantages, but many opportunities for error in a busy blood bank. This study was aimed at reviewing the potential for human errors with new students compared to experienced MLS (5-16 years). When performing antigen testing there are numerous opportunities for errors, as observed in this study with an experienced MLS who miss typed a K antigen. This only demonstrates that no one is free from making a mistake and all opportunities to decrease errors would be beneficial to patient care. As staffing constraints become even more stringent, incorporating automation may help. With instrumentation, the financial cost for reagents and labor must be considered, yet the cost of a human error in transfusion medicine might outweigh those concerns.
