Background/Case Studies: Blood administration requires verification at the patient bedside that the correct blood product is going to be going to the correct patient. Many institutions use electronic barcode verification processes (EBVP) to complete the verification. It is great when the EVBP works as designed but there are multiple situations when things do not go as designed or are not practical and manual verification and documentation are needed. A downtime process needs to be able to be implemented quickly especially during Emergency Release and Massive Transfusion Protocol situations.
Study
Design/Methods: As part of moving to a new computer system 3 years ago, the blood product patient tag (PTAG) was redesigned to include automatically printing the patient information and unit information as one label that included a tear off with duplicate information. This duplicate label is always available so that when last minute downtime is required, the needed information is immediately available. The duplicate label is placed on a paper Transfusion Administration Record (TAR) where the dual beside verification can be documented along with all the other regulatory required steps of start and stop times, vital signs during transfusion and volume of blood that has been given. The paper TARs can be easily sent with the blood products or stored in the clinical area for use at any time. When the Transfusion Service (TS) computer system is not available to print the PTAG, a fillable PDF file is used to type in the unit and patient information so that it can be printed and look just like the automated label process. The PDF was designed to automatically fill in the bottom duplicate information so that it does not need to be entered twice. This is extremely helpful to prevent FDA reportable errors associated with incorrect PTAG information.
Results/Findings: A streamline process has developed to automatically include downtime paperwork when sending blood that is needed for Emergency Release or MTP. The downtime process is also immediately available when there are problems scanning at the bedside or when there is a Hospital Information System (HIS) downtime and EVBP is not an option. We have removed the need to have a separate downtime process to be enacted only on rare occasions. Conclusions: Having the second label built into the routine PTAG makes it easy to switch to downtime even if needed at the last minute. Knowing that a label can easily be generated that looks exactly the same as the routine label using the writable PDF file also allows for easy reading and verification and less stress when the TS computer system is not immediately. Previously we had at least 1 reportable error a year due to manual documentation of the PTAG and this error has not occurred since using the PDF version of the PTAG.
Importance of research: Downtime does not occur often but there are times when manual blood administration documentation is part of a common workflow. Our institution created a Patient/ Unit Tag (PTAG) that has a built-in downtime label so that manual paperwork can easily be created without having to go to handwriting each tag and form. Our institution also was able to create a writeable PDF file that can be used during downtime to generate a typed PTAG to fulfill our downtime needs.
