Blood Type Verification Rejection Rate Reduction

Abstract

Abstract Introduction/Objective Specimen collection is an initial pre-analytical process that ensures accurate, reliable, and timely patient results. In accordance with AABB and CAP Standards, Transfusion Service rejects specimens if they do not meet predefined technical requirements for each specific analyte. First-time patients admitted to Stanford Health Care (SHC), requiring blood transfusions, must have a current blood type on file. The blood type must be confirmed with a second, independent blood specimen called the Blood Type Verification (BTVI). Collection of the BTVI ensures that the patient’s blood type is confirmed. This is required in order to help prevent transfusion of ABO-incompatible blood products, which could result in a potentially severe transfusion reaction. SHC policy requires the Type and Screen (TNS) and BTVI to be drawn at least one minute apart. If collected at the same time, the BTVI specimen is rejected a and a redraw is requested. This process could potentially delay patient care and cause patient discomfort. Methods/Case Report It was identified that a key component to decrease specimen rejections would be to leverage technology to drive adherence to policy, rather than rely on human-driven, manual processes. In collaboration with Nursing and IT, a technological mechanism was developed to disallow the printing of the BTVI label until the TNS is documented as collected within the electronic health record (EHR). The BTVI would be accessible one minute after the TNS is collected to ensure that a second, independent patient verification is completed. The IT solution ensures that the documentation time follows policy and standards, which, enhances patient safety by reminding staff to complete a second patient verification as needed Results (if a Case Study enter NA) We implemented the IT solution for BTVI in October 2022. The BTVI rejection rate for samples accounted for 52% of overall rejected specimens in the department. In October, November, and December, the BTVI sample rejection rate accounted for 47%, 10%, and 0% of overall rejected samples in the department, respectively. We continue to monitor BTVI rejection rates closely to ensure that the IT solution is working as expected and that standard workflow is followed per SHC policy Conclusion This IT enhancement has improved patient safety by ensuring that accurate blood type is determined to provide cross- matched blood products to patients in a timely manner. Additionally,, it has improved patient care by reducing the number of redraws and preventing transfusion delays.