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首页> 外文期刊>JMIR Medical Informatics >Implementation and Effectiveness of a Bar Code–Based Transfusion Management System for Transfusion Safety in a Tertiary Hospital: Retrospective Quality Improvement Study
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Implementation and Effectiveness of a Bar Code–Based Transfusion Management System for Transfusion Safety in a Tertiary Hospital: Retrospective Quality Improvement Study

机译：三级医院输血安全的基于条形码的输血管理系统的实施和有效性：回顾性质改进研究

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Background Large-scale and long-term studies are not sufficient to determine the efficiency that IT solutions can bring to transfusion safety. Objective This quality-improvement report describes our continuous efforts to implement and upgrade a bar code–based transfusion management (BCTM) system since 2011 and examines its effectiveness and sustainability in reducing blood transfusion errors, in a 3000-bed tertiary hospital, where more than 60,000 prescriptions of blood transfusion are covered by 2500 nurses each year. Methods The BCTM system uses barcodes for patient identification, onsite labeling, and blood product verification, through wireless connection to the hospital information systems. Plan-Do-Study-Act (PDSA) cycles were used to improve the process. Process maps before and after implementation of the BCTM system in 2011 were drawn to highlight the changes. The numbers of incorrect labeling or wrong blood in tube incidents that occurred quarterly were plotted on a run chart to monitor the quality changes of each intervention introduced. The annual occurrences of error events from 2011 to 2017 were compared with the mean occurrence of 2008-2010 to determine whether implementation of the BCTM system could effectively reduce the number of errors in 2016 and whether this reduction could persist in 2017. Results The error rate decreased from 0.03% in 2008-2010 to 0.002% in 2016 (P.001) and 0.001% in 2017 (P.001) after implementation of the BTCM system. Only one incorrect labeling incident was noted among the 68,324 samples for blood typing, and no incorrect transfusions occurred among 67,423 transfusion orders in 2017. Conclusions This report demonstrates that continuous efforts to upgrade the existing process is critical to reduce errors in transfusion therapy, with support from information technology.
机译：背景技术大规模和长期研究不足以确定IT解决方案可以带来输血安全的效率。目的这一质量改进报告介绍了自2011年以来实施和升级基于条形码的输血管理（BCTM）系统的持续努力，并在3000床三级医院中检查减少血液输血误差时的有效性和可持续性每年覆盖60,000例药物输血。方法通过与医院信息系统的无线连接，BCTM系统使用用于患者识别，现场标记和血液产品验证的条形码。计划 - DO-STAIL-ACT（PDSA）循环用于改善过程。在2011年实施BCTM系统之前和之后的过程映射被绘制以突出显示更改。在运行图表中绘制了季度发生的管道事件中的标签或错误血液的数量，以监测所引入的每个干预的质量变化。将2011年至2017年的错误事件发生的年度发生的错误事件与2008 - 2010年的平均发生进行了比较，以确定BCTM系统的实施是否可以有效地减少2016年的错误数量，并在2017年持续存在。结果错误率2016年2008-2010的0.002％下降至0.002％（P <.001）和2017年的0.001％（P <.001）实施BTCM系统后。在68,324个样本中仅注意到了一个不正确的标签事件，2017年在67,423个输血令中没有发生不正确的输血。结论本报告表明，升级现有过程的不断努力对于减少输血治疗中的错误至关重要，以支持从信息技术。

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