KMID : 0356920200730030232
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Korean Journal of Anesthesiology 2020 Volume.73 No. 3 p.232 ~ p.238
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A novel approach to bedside pretransfusion identity check of blood and its components: the Sandesh Positive-Negative protocol
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Udupi Sandesh
Puri Kriti
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Abstract
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Background: Blood component mistransfusion is generally due to preventable clerical errors, specifically pretransfusion misidentification of patient/blood unit at bedside. Hence, electronic devices such as barcode scanners are recommended as the standard instrument used to check the patient¡¯s identity. However, several healthcare facilities in underdeveloped countries cannot afford this instrument; hence, they usually perform subjective visual assessment to check the patient¡¯s identity. This type of assessment is prone to clinical errors, which precipitates significant level of anxiety in the healthcare personnel transfusing the blood unit. Hence, a novel objective method in performing pretransfusion identity check, the ¡®Sandesh Positive-Negative (SPON) protocol,¡¯ was developed.
Methods: A nonrandomized study on bedside pretransfusion identity check was conducted, and 75 health care personnel performed transfusion. The intervention was performed by matching a custom-made negative label with blood component with the positive label of the same patient available at bedside who was about to receive transfusion.
Results: In total, 85.3% of the subjects were anxious while performing pretransfusion identity check based on the existing standard practice. After the implementation of the SPON protocol, only 38.7% experienced either mild, moderate or severe anxiety. The overall level of satisfaction also increased from 8.0% to 38.7% and none were dissatisfied. Although only 9.3% were dissatisfied about the existing practice, approximately 70.7% felt the need for a better/additional protocol. Clerical error was not observed.
Conclusions: The SPON protocol is a cost-effective objective method that reduces anxiety and increases satisfaction levels when performing final bedside identity check of blood components.
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KEYWORD
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Blood component transfusion, Blood safety, Errors, Hemovigilance, Mistransfusion, Novel intervention, Organization and administration, Prevention and control, Standards
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