Aspects Of Patient Safety Research Articles

A mixed-methods evaluation of the MOREOB program in Ontario hospitals: participant knowledge, organizational culture, and experiences

BackgroundMOREOB (Managing Obstetrical Risk Efficiently) is a patient safety program for health care providers and administrators in hospital obstetric units. MOREOB has been implemented widely in Canada and gradually spread to the United States. The main goal of MOREOB is to build a patient safety culture and improve clinical outcomes. In 2013, 26 Ontario hospitals voluntarily accepted provincial funding to participate in MOREOB. The purpose of our study was to assess the effect of MOREOB on participant knowledge, organizational culture, and experiences implementing and participating in the program at these 26 Ontario hospitals.MethodsA convergent parallel mixed-methods study in Ontario, Canada, with MOREOB participants from 26 hospitals. The quantitative component used a descriptive pre-post repeated measures design to assess participant knowledge and perception of culture, administered pre-MOREOB and after each of the three MOREOB modules. Changes in mean scores were assessed using mixed-effects regression. The qualitative component used a qualitative descriptive design with individual semi-structured interviews. We used content analysis to code, categorize, and thematically describe data. A convergent parallel design was used to triangulate findings from data sources.Results308 participants completed the knowledge test, and 329 completed the culture assessment at all four time points. Between baseline and post-Module 3, statistically significant increases on both scores were observed, with an increase of 7.9% (95% CI: 7.1 to 8.8) on the knowledge test and an increase of 0.45 (on a scale of 1–5, 95% CI: 0.38 to 0.52) on the culture assessment. Interview participants (n = 15) described improvements in knowledge, interprofessional communication, ability to provide safe care, and confidence in skills. Facilitators and barriers to program implementation and sustainability were identified.ConclusionsParticipants were satisfied with their participation in the MOREOB program and perceived that it increased health care provider knowledge and confidence, improved safety for patients, and improved communication between team members. Additionally, mean scores on knowledge tests for obstetric content and culture assessment improved. The MOREOB program can help organizations and individuals improve care by concentrating on the human and organizational aspects of patient safety. Further work to improve program implementation and sustainability is required.

Reducing risk in equine anaesthesia part 2: specific risk factors, human factors and safety checklists

Performing general anaesthesia in horses carries an inherent risk. Knowledge of the physiological, pharmacological and practical considerations unique to horses is important to be able to minimise this risk and to address complications should they arise. This article discusses the physiological considerations of subsets of the equine population; aspects of human and patient safety; and methods to reduce human error.

Tele-emergency physician : New care concept in emergency medicine

Telemedical concepts, already successfully established in various clinical areas, such as radiology, are increasingly being implemented in the preclinical setting throughout Germany (tele-emergency physician). The aim of the article is to present the objectives and requirements as well as the practical implementation and the potential indications for atelemedical emergency system in the preclinical situation. Discussion of scientific facts and expert recommendations, specifically from experiences of the tele-emergency physician (Telenotarzt) project in an urban environment (City of Aachen). In addition, reference is made to asecond pilot project in arural region (Straubing, Bavaria). The successful implementation of aprehospital telemedical emergency system requires aspecific framework, in particular of a legal and technical nature. In order to achieve optimal process quality it is important to establish acomprehensive concept that takes aspects of patient safety into account. The entire dispatch process in the control center as well as the training of all involved personnel must also be taken into consideration. With its special structures and processes, the overall concept of the telemedical emergency physician meets the changing challenges in the preclinical healthcare system and opens up new possibilities for patient care that meet the current requirements.

Time to take a breath: Rebalancing the human and technical aspects of patient safety

Time to take a breath: Rebalancing the human and technical aspects of patient safety

Reducing risk in equine anaesthesia part 1: recognising risk factors and addressing common complications

Performing general anaesthesia in horses carries an inherent risk. Knowledge of the physiological, pharmacological and practical considerations unique to horses is important to be able to minimise this risk and to address complications should they arise. This article discusses the factors known to increase and to reduce anaesthetic risk, and some of the common complications encountered; part 2 will address the physiological considerations of subsets of the equine population; aspects of human and patient safety; the importance of close observation and monitoring; and methods to reduce human error.

Automated classification of primary care patient safety incident report content and severity using supervised machine learning (ML) approaches.

Learning from patient safety incident reports is a vital part of improving healthcare. However, the volume of reports and their largely free-text nature poses a major analytic challenge. The objective of this study was to test the capability of autonomous classifying of free text within patient safety incident reports to determine incident type and the severity of harm outcome. Primary care patient safety incident reports (n=31333) previously expert-categorised by clinicians (training data) were processed using J48, SVM and Naïve Bayes.The SVM classifier was the highest scoring classifier for incident type (AUROC, 0.891) and severity of harm (AUROC, 0.708). Incident reports containing deaths were most easily classified, correctly identifying 72.82% of reports. In conclusion, supervised ML can be used to classify patient safety incident report categories. The severity classifier, whilst not accurate enough to replace manual processing, could provide a valuable screening tool for this critical aspect of patient safety.

Patient Safety in the Aspect of Process and Procedures Connected with Medical Services

Abstract In the paper the risks to which the patient is exposed while receiving a medical service have been analyzed. All treatments related to blood collection from the patient deserve much attention. It consists of a number of principles and procedures regarding the patient's health safety as well as safety of a person providing this service. Prevention and preventive actions in the aspect of patient safety in the face of threats resulting from the nature of medical services provided are a priority. Due to preventive action it is possible to avoid the effects of exposure to biological hazards, including the possibility of becoming infected with HIV, HCV and HBV. In the paper the results of a questionnaire survey carried out in selected blood stations of the Śląskie Voivodeship have been presented. The questionnaire is able to collect the information about patient awareness on the risks of the medical service (blood collection).

Patient Safety: A Deep Concern to Caregivers.

Patient safety is a global concern and is the most important domains of health-care quality. Medical error is a major patient safety concern, causing increase in health-care cost due to mortality, morbidity, or prolonged hospital stay. A definition for patient safety has emerged from the health care quality movement that is equally abstract, with various approaches to the more concrete essential components. Patient safety was defined by the IOM as "the prevention of harm to patients." Emphasis is placed on the system of care delivery that prevents errors; learns from the errors that do occur; and is built on a culture of safety that involves health care professionals, organizations, and patients. Patient safety culture is a complex phenomenon. Patient safety culture assessments, required by international accreditation organizations, allow healthcare organizations to obtain a clear view of the patient safety aspects requiring urgent attention, identify the strengths and weaknesses of their safety culture, help care giving units identify their existing patient safety problems, and benchmark their scores with other hospitals.

A new approach of assessing patient safety aspects in routine practice using the example of "doctors handwritten prescriptions".

Aims and objectivesTo test the method of self‐ and external assessment as a feedback system to decrease illegibility and incorrectness of handwritten prescriptions and to reduce additional workload for nursing staff.BackgroundIllegibility and incorrectness of handwritten prescriptions occur very often and are the most crucial factors affecting patient safety.DesignSelf‐ versus external assessment using a 15 items checklist.MethodsNurses randomly selected five fever charts of their wards. Each fever chart was self‐ as well as externally assessed. Nurses and doctors took part in the self‐assessment, and the external assessment was performed by external experts. According to a monitor suspension system, assessment results were considered “green,” “yellow” or “red.” After the first assessment and issuing feedback of the results “red” scored wards by the external assessment, additional trainings were performed. Thereafter, a second assessment was performed to rate eligibility and completeness of prescriptions. The research and reporting methodology followed squire 2.0.ResultsIn total, 580 fever charts were self‐ as well as externally assessed (290 in each of the two assessment periods). Out of the 58 participating wards, 31 were surgical and 27 were non‐surgical wards. Averaging over all checklist items, surgical and non‐surgical wards improved only slightly over time. Linear regression models for ward means showed that there were significant improvements over time for non‐surgical wards.ConclusionsThis method directly involves those who commit errors and stimulate learning from errors. The approach of self‐ and external assessment was a useful instrument to detect inadequate prescriptions and to monitor improvements.Relevance to clinical practiceSignificant improvements were achieved regarding correctness and legibility of handwritten prescription and helped to decrease additional workload for nursing staff and thereby enhanced patient safety.

A survey of hospital healthcare professionals’ perceptions toward patient safety culture in Saudi Arabia

BackgroundMedical and allied health professionals should adopt error reduction as a key strategic priority and make patient safety improvement an ongoing, active process within their organization. ObjectiveThe present study investigates the perceptions of healthcare professionals toward patient safety culture in hospitals throughout Hail Region, Kingdom of Saudi Arabia. MethodsThis research, which uses a descriptive cross-sectional approach to evaluate the perceptions of healthcare professionals toward patient safety culture, was conducted at four major hospitals in Hail Region, Kingdom of Saudi Arabia and involved 255 healthcare professionals, who served as respondents based on systematic random sampling. Standard deviation and the chi-square test of independence were used for statistical analysis. This study was approved by the Ethics Review Committee (H-2016-057) of the University of Hail. ResultsAmong the patient safety aspects, patient safety grade received the highest mean value (3.56 ± 0.72), whereas handoffs and transitions received the least consensus (3.00 ± 0.34). Interestingly, hospital work experience significantly correlated to work area (p = 0.026), communications (p = 0.037), and the number of events reported (p = 0.019) in the patient safety dimension. Moreover, the number of years in the area/unit significantly related to the work area (p = 0.047) and supervisor/manager (p = 0.009). Only the number of events reported showed a significant relationship with specialty or profession (p = 0.007). ConclusionHealthcare professionals have an affirmative view toward patient safety culture aspects, and positive relationships were found between the patient safety dimensions and study participants’ profile. The findings presented herein suggest that healthcare professionals affirm the practice of patient safety culture. However, further research is required to continuously appraise the significance of healthcare-based quality indicators. Overall, the assessment results suggest a platform for better intervention and transformation procedures targeting the promotion of patient safety culture.

Healthcare professionals' competence in digitalisation: A systematic review.

To identify key areas of competence for digitalisation in healthcare settings, describe healthcare professionals' competencies in these areas and identify factors related to their competence. Digitalisation requires changes in healthcare practices, policies and actions to revise job expectations and workflows. The aspects of patient safety and integration of digitalisation into the professional context necessitate an assessment of healthcare professionals' competencies in digitalisation. Systematic review. A systematic review was conducted following Center of Reviews and Dissemination guidelines, including application of a PRISMA statement. Four databases-CINAHL (EBSCO), MEDLINE (Ovid), Web of Science and Academic Search Premiere (EBSCO)-were searched for relevant original peer-reviewed studies published between 2012-2017. Twelve were chosen for final analysis: five quantitative studies and seven qualitative studies, which were, respectively, subjected to narrative and thematic synthesis. Key competence areas regarding digitalisation from a healthcare perspective identified encompass knowledge of digital technology and the digital skills required to provide good patient care, including associated social and communication skills, and ethical considerations of digitalisation in patient care. Healthcare professionals need the motivation and willingness to acquire experience of digitalisation in their professional context. Collegial and organisational support appear to be essential factors for building positive experiences of digitalisation for healthcare professionals. Healthcare organisations should both pay attention to the social environment of a workplace and create a positive atmosphere if they want to improve the response to digitalisation. The successful implementation of new technology requires organisational and collegial support. Recommendations for clinical practice include the following: development of competence in digitalisation by healthcare professionals when using technological equipment to minimise errors; provision of sufficient resources, equipment and room for technology usage; and provision of regular education that considers the participants' competencies.

Does Nursing Home Compare Reflect Patient Safety In Nursing Homes?

The past several decades have seen significant policy efforts to improve the quality of care in nursing homes, but the patient safety movement has largely ignored this setting. In this study we compared nursing homes' performance on several composite quality measures from Nursing Home Compare, the most prominent recent example of a national policy aimed at improving the quality of nursing home care, to their performance on measures of patient safety in nursing homes such as pressure sores, infections, falls, and medication errors. Although Nursing Home Compare captures some aspects of patient safety, we found the relationship to be weak and somewhat inconsistent, leaving consumers who care about patient safety with little guidance. We recommend that Nursing Home Compare be refined to provide a clearer picture of patient safety and quality of life, allowing consumers to weight these domains according to their preferences and priorities.

188 Impact of Adult Level 1 Trauma Designation on the Timeliness of Pediatric Emergency Department Computed Tomography Scans

Timeliness in the provision of medical care is an essential aspect of patient safety and health care quality. Given the unpredictable nature of the emergency department (ED) with regards to variation in disease acuity and patient volume, it is essential to gather crucial information in a prompt fashion to aid medical decisionmaking and patient disposition. The adult emergency department of our institution was verified as a Level 1 Trauma Center by the American College of Surgeons in December 2015, 24 years after our pediatric emergency department was recognized as a Level 1 Trauma Center. One of the metrics used as an operational benchmark in the ED is imaging interval (time from order of an imaging test to the availability of results). There is a single computed tomography (CT) scanner located in the emergency department, which is utilized by both the adult and pediatric sections. With an anticipated increase in the adult ED patient volume following its new status, we sought to assess the impact of adult Level 1 Trauma designation on the timeliness of pediatric non-trauma CT scans in an emergency department. Retrospective chart review of patients in the pediatric emergency department who had CT scans was performed. We compared CT scan orders of patients over the same 6-month period prior to and after the adult ED Level 1 Trauma verification, and assessed the time from order to completion of CT scans. The months with historically highest trauma volumes were chosen. All pediatric trauma activations were excluded, as well as duplicate orders and scans performed during EMR downtime. Unpaired student t-tests and Chi-squared tests were used for statistical analyses. There were 218 consecutive CT scans analyzed in 2015, and 193 consecutive CT scans in the same time frame in 2016. About half of the CT scans in both years were head imaging studies, and more males were scanned compared to females. The average time for CT completion prior to adult ED Level 1 verification was 39.5 minutes, compared to 55.5 minutes in the same time frame the next year (p<0.0001). Also, the proportion of children receiving CT scans within 60 minutes from order decreased from 81% in 2015 to 65% in 2016. (p=0.0002; 95% CI 7.4 - 24.4). The new designation of adult Level 1 trauma status in our ED was associated with a significant delay (by more than 40%) in performance of non-trauma pediatric CT scans, and decrease in the likelihood of children receiving CT scans within 60 minutes. These findings may have significant clinical and economic ramifications for pediatric patients and hospitals, and represent the potential "collateral damage" of an institution receiving an upgrade of their adult trauma center to Level 1 status.

Impact of medication reconciliation for improving transitions of care.

Transitional care provides for the continuity of care as patients move between different stages and settings of care. Medication discrepancies arising at care transitions have been reported as prevalent and are linked with adverse drug events (ADEs) (e.g. rehospitalisation).Medication reconciliation is a process to prevent medication errors at transitions. Reconciliation involves building a complete list of a person's medications, checking them for accuracy, reconciling and documenting any changes. Despite reconciliation being recognised as a key aspect of patient safety, there remains a lack of consensus and evidence about the most effective methods of implementing reconciliation and calls have been made to strengthen the evidence base prior to widespread adoption. To assess the effect of medication reconciliation on medication discrepancies, patient-related outcomes and healthcare utilisation in people receiving this intervention during care transitions compared to people not receiving medication reconciliation. We searched CENTRAL, MEDLINE, Embase, seven other databases and two trials registers on 18 January 2018 together with reference checking, citation searching, grey literature searches and contact with study authors to identify additional studies. We included only randomised trials. Eligible studies described interventions fulfilling the Institute for Healthcare Improvement definition of medication reconciliation aimed at all patients experiencing a transition of care as compared to standard care in that institution. Included studies had to report on medication discrepancies as an outcome. Two review authors independently screened titles and abstracts, assessed studies for eligibility, assessed risk of bias and extracted data. Study-specific estimates were pooled, using a random-effects model to yield summary estimates of effect and 95% confidence intervals (CI). We used the GRADE approach to assess the overall certainty of evidence for each pooled outcome. We identified 25 randomised trials involving 6995 participants. All studies were conducted in hospital or immediately related settings in eight countries. Twenty-three studies were provider orientated (pharmacist mediated) and two were structural (an electronic reconciliation tool and medical record changes). A pooled result of 20 studies comparing medication reconciliation interventions to standard care of participants with at least one medication discrepancy showed a risk ratio (RR) of 0.53 (95% CI 0.42 to 0.67; 4629 participants). The certainty of the evidence on this outcome was very low and therefore the effect of medication reconciliation to reduce discrepancies was uncertain. Similarly, reconciliation's effect on the number of reported discrepancies per participant was also uncertain (mean difference (MD) -1.18, 95% CI -2.58 to 0.23; 4 studies; 1963 participants), as well as its effect on the number of medication discrepancies per participant medication (RR 0.13, 95% CI 0.01 to 1.29; 2 studies; 3595 participants) as the certainty of the evidence for both outcomes was very low.Reconciliation may also have had little or no effect on preventable adverse drug events (PADEs) due to the very low certainty of the available evidence (RR 0.37. 95% CI 0.09 to 1.57; 3 studies; 1253 participants), with again uncertainty on its effect on ADE (RR 1.09, 95% CI 0.91 to 1.30; 4 studies; 1363 participants; low-certainty evidence). Evidence of the effect of the interventions on healthcare utilisation was conflicting; it probably made little or no difference on unplanned rehospitalisation when reported alone (RR 0.72, 95% CI 0.44 to 1.18; 5 studies; 1206 participants; moderate-certainty evidence), and had an uncertain effect on a composite measure of hospital utilisation (emergency department, rehospitalisation RR 0.78, 95% CI 0.50 to 1.22; 4 studies; 597 participants; very low-certainty evidence). The impact of medication reconciliation interventions, in particular pharmacist-mediated interventions, on medication discrepancies is uncertain due to the certainty of the evidence being very low. There was also no certainty of the effect of the interventions on the secondary clinical outcomes of ADEs, PADEs and healthcare utilisation.

Measurement tools and outcome measures used in transitional patient safety; a systematic review.

BackgroundPatients are at risk for harm when treated simultaneously by healthcare providers from different healthcare organisations. To assess current practice and improvements of transitional patient safety, valid measurement tools are needed.Aim and methodsTo identify and appraise all measurement tools and outcomes that measure aspects of transitional patient safety, PubMed, Cinahl, Embase and Psychinfo were systematically searched. Two researchers performed the title and abstract and full-text selection. First, publications about validation of measurement tools were appraised for quality following COSMIN criteria. Second, we inventoried all measurement tools and outcome measures found in our search that assessed current transitional patient safety or the effect of interventions targeting transitional patient safety.ResultsThe initial search yielded 8288 studies, of which 18 assessed validity of measurement tools of different aspects of transitional safety, and 191 assessed current transitional patient safety or effect of interventions. In the validated measurement tools, the overall quality of content and structural validity was acceptable; other COSMIN criteria, such as reliability, measurement error and responsiveness, were mostly poor or not reported. In our outcome inventory, the most frequently used validated outcome measure was the Care Transition Measure (n = 9). The most frequently used non-validated outcome measures were: medication discrepancies (n = 98), hospital readmissions (n = 55), adverse events (n = 34), emergency department visits (n = 33), (mental or physical) health status (n = 28), quality and timeliness of discharge summary, and patient satisfaction (n = 23).ConclusionsAlthough no validated measures exist that assess all aspects of transitional patient safety, we found validated measurement tools on specific aspects. Reporting of validity of transitional measurement tools was incomplete. Numerous outcome measures with unknown measurement properties are used in current studies on safety of care transitions, which makes interpretation or comparison of their results uncertain.

Patient safety culture as a quality indicator for a safe health system: Experience from Almadinah Almunawwarah, KSA.

ObjectivesSafety culture assessments allow healthcare organisations to get a clear understanding of those aspects of patient safety requiring urgent attention and highlight safety culture strengths and weaknesses. This study aimed to evaluate the extent to which the culture supports patient safety at a hospital in KSA.MethodsA cross-section analytical observational study was conducted at King Fahad Hospital in Almadinah Almunawwarah, KSA.ResultsAfter the survey, the staff felt less certain about the patient safety culture inside the institution. The greatest positive scores were obtained for teamwork within units, safety culture composites, feedback, communication about error, management expectations, actions promoting patient safety, organisational learning, and continuous improvement. However, none of these features achieved a positive score of 75% or more as an area of strength. The rest of the aspects were negatively ranked as areas for probable development, with the lowest scores obtained for non-punitive reaction to error, staffing, hospital handoff and transition, communication openness, and hospital management support for patient safety.ConclusionCommitment to quality care as an outcome is certainly correlated with patient safety. There is a strong need to improve and promote applicable policies to improve the culture of patient safety in hospitals. The development of strong management competence to promote an environment of open consultation and administrative wisdom will contribute to improving patient safety culture.

Factors affecting readiness for discharge and perceived social support after childbirth.

To evaluate the factors affecting readiness for discharge and perceived social support after childbirth. Many women still die during and following pregnancy and childbirth. Both early and late discharges are conflicting issues in the world. Evaluation of the readiness for discharge in terms of patient safety, satisfaction, physical, emotional, psychological and social aspects is important. Descriptive and cross-sectional study. The study was carried out with 610 women in the early postpartum period at two hospitals in Turkey between October 2014-March 2015 using Readiness for Hospital Discharge Scale-New Mother Form and Multidimensional Scale of perceived social support. The mean scores for Readiness for Hospital Discharge Scale-New Mother Form and Multidimensional Scale of perceived social support were found as 163.5 (SD: 34.1) and 64.2 (SD: 18.8), respectively. Women who were discharged from Merkezefendi Hospital, women who had one child or one pregnancy and women or baby who experienced complication during or after birth had lower scores on Readiness for Hospital Discharge Scale-New Mother Form. Women who received information about the postpartum period had significantly higher scores on the total Readiness for Hospital Discharge Scale-New Mother Form than women did not (165.5±33.8 vs 151.1±36.1). Personal status, knowledge and total score of the Readiness for Hospital Discharge Scale-New Mother Form were significantly higher in women who were ready for discharge. Findings provide vital information that can inform nursing clinical practice, especially related to readiness for discharge protocols and developing strategies for women, who had low sociodemographic backgrounds, did not have any information about postpartum period and were not ready for discharge. The mother and family face with postpartum difficulties on their own when early discharge takes place. Providing postpartum care services plays an important role for maternal-child health.

Exploring the experiences and opinions of hospital pharmacists working 24/7 shifts

ObjectivesThe expansion of out-of-hours pharmacy services results from a drive to improve patient care and promote integration into the wider healthcare team. However, there has been little attempt to explore...

Exploring Factors Contributing to Medication Errors with Opioids in Australian Specialist Palliative Care Inpatient Services: A Multi-Incident Analysis.

Opioid errors have the potential to cause significant patient harm. These high-risk medications are used in high volumes in palliative care services to manage pain and other symptoms. Palliative patients are at greater risk of harm from opioid errors, as they are generally older and taking numerous medications to manage multiple comorbidities. Understanding factors contributing to opioid errors in inpatient palliative care services is a largely underexplored, yet, essential aspect of patient safety. To explore and identify the characteristics and associated contributing factors of reported opioid errors in palliative care inpatient services using a multi-incident analysis framework. A multi-incident analysis of opioid errors reported over three years in two Australian specialist palliative care inpatient services. A total of 78 opioid errors were reported. The majority (76%) of these errors occurred during opioid administration, primarily due to omitted dose (34%) and wrong dose (17%) errors. Eighty-five percent of reported errors reached the patient resulting in opioid underdose for over half (59%) of these patients. Over one-third (37%) of errors caused patient harm, which required clinical intervention. Error contributing factors included the following: noncompliance with policy; individual factors such as distraction; poor clinical communication systems; and workload. This multi-incident analysis has provided initial insights into factors contributing to opioid errors in palliative care inpatient services. Further exploration is warranted to understand palliative care clinicians' perspectives of systems, individual, and patient factors that influence safe opioid delivery processes.

The risk of transfusion transmissible infections. Where do we stand in 2018?

Blood transfusion is an important aspect of medicine and patient safety plays a very important role. A myriad of blood-borne infectious agents can be potentially transmitted through transfusion of blood and blood products donated by apparently healthy and asymptomatic donors. The diversity of infectious agents includes human immunodeficiency viruses 1 and 2, hepatitis B virus, hepatitis C virus, malaria, syphilis, human T-lymphotropic virus types 1 and 2 and in certain circumstances, hepatitis A virus, cytomegalovirus, parvovirus B19, and many more. Besides the established viral, bacterial, and parasitic diseases, novel agents have now appeared and are still emerging as potential threats in transfusion medicine. While transmission of prion protein causing variant Creutzfeldt–Jakob disease is of prime concern in countries like the United Kingdom (UK), bacterial infections and viruses such as Dengue and Chikungunya are of prime concern in the Asian region. Transfusion centers employ three levels of screening to ensure blood safety: donor screening interventions to exclude high-risk donors, testing for infectious markers by serology, nucleic acid testing methods and processing technologies like leukoreduction, use of diversion pouch in blood collection, and use of aseptic blood collection technique. Implementing new technologies like pathogen reduction to destroy/inactivate pathological substances in blood components using chemicals or UV lights coupled with expanding testing for emerging diseases will certainly increase the safety of blood. The ultimate aim is to minimize the risks of transfusion-transmitted infection during the window period of infectious agent in a cost-effective and efficient manner. Although considerable effort and resources have been invested, no single technique is yet effective and we are far from achieving zero risk. The main challenges are faced by developing countries due to limited resources.