(P-TS-69) Improving Bedside Scanning of Blood Products

Background/Case Studies: Since going live with bedside scanning using our Hospital Information System (HIS) we have struggled to consistently be able to scan the blood products without computer errors. Often the Transfusion Service (TS) is called when the floor is unable to scan at the bedside, but the TS has little that can be done except verify that the blood products have been issued in the computer system. This leads to frustration and requests for new blood products to be sent to the patient bedside. The original unit may get returned but is often wasted due to being out of temperature.

Study

Design/Methods: Complaints from the floor were entered into the patient safety event tracking system and found to be a recurring issue especially in certain departments of the hospital. Compliance reports were obtained and Nursing Leadership and Quality reached out to Clinical Informatics (CI), Information Technology (IT), and Nursing Education to assess the failures. These teams worked with specific departments and verified the scanning errors and what caused the errors.

Results/Findings: IT determined that new scanners had been purchased and installed by the department without programming to include blood product scanning. The blood products have a unique requirement to turn off the “concatenation” feature. This feature allows scanning of multiple barcodes at one time but results in many of the errors that the departments were seeing. IT developed a new program scanning sheet that includes turning off the concatenation and included a donor identification number (DIN) barcode to verify that the blood product scanning would work. Other errors identified with Nursing workflow included trying to scan on the incorrect product type order or on an order that had been cancelled. In 2023 there were over 2500 scanning Compliance Errors (CEs) at one site (average of 3.0% of total scans in the region). After interventions and education there was a drastic decrease in CEs from January to April of 2024. The decrease in CEs has remained steady for the last 12 months with a total of 436 CEs, which is down to a consistent rate of 0.5% CEs for the system.

Conclusions: IT went to the departments that had the most errors and reprogrammed all the scanners in the department. This resulted in a huge decrease in scanning failures as well as far fewer complaints to the TS. CI and nursing education rounded with high failure areas as well to reinforce correct workflow and how to identify the correct order to use for scanning. The updated programming of the scanners and the review of the workflow has led to a huge decrease in CEs. Improved results have resulted in a decrease in delays and is a win for everyone as it contributes to safer blood transfusions for the patients.