The immunohematologic and patient safety benefits of a centralized transfusion database

Abstract

The transfusion medical record is an important tool for providing safe and appropriate blood. However, many patients seek care at more than one hospital and this record is usually not portable. We posited that a centralized transfusion service database (CTS-D) offers benefits through tracking blood types, transfusion requirements, and detecting wrong blood in tube (WBIT). Records held in the CTS-D from 1997 to 2010 were queried to enumerate those seen at more than one hospital versus one hospital only. Transfusion-related attributes were collected including red blood cell (RBC) antibodies, transfusion requirements, and reactions. WBITs detected due to historical ABO typing were tallied. A review of blood orders that required alteration based on requirements held in the CTS-D was completed. There were 724,584 records; 10.9% of patients had been tested or received blood transfusion at more than one hospital. Of the 63,973 records with RBC alloantibodies, a greater proportion of patients were seen at more than one hospital versus one hospital only (7.11% vs. 3.97%, p < 0.005). Of the 97,687 patient records that required special processing, patients seen at one hospital had a lower rate than those at more than one hospital (12.13% vs. 24.59%, p < 0.005). There were 77 WBITs (0.18 WBITs per 1000 patients). An in-depth review of WBITs found an additional 26.3% (5 of 19) were detected because the current and historical ABO types were from two different hospitals within the CTS. The CTS-D provides a universal transfusion record that improves patient safety. As health care systems are enlarged, centralization of the transfusion component of the medical record should be considered.