Electronic positive patient identification, computer provider order entry, and electronic remote blood issue implemented in operating rooms improve the safety and efficiency of blood transfusions.

INTRODUCTION

Blood transfusions are routinely performed in operation rooms. The process chain of performing ABO type, antibody screen, crossmatch, blood transport, and patient verification is complex. A multidisciplinary task force convened to improve the process of blood ordering and utilization identified 3 issues: (1) blood orders performed on paper included transcription errors; (2) guidelines for blood ordering practices were lacking, with inappropriate and arbitrary requests; and (3) there were long intervals between ordering and receiving blood in the operating room because of its distance from the blood bank.

METHODS

The task force implemented (1) an electronic positive patient identification (ePPID) system, (2) a standardized computer provider order entry (CPOE) for ordering blood for surgical patients, and (3) an electronic remote blood issuing (ERBI) system using refrigerators located within the operating suite.

RESULTS

Following ePPID implementation, transfusion documentation compliance rates improved from 71% to 98% and detected 2 patient safety issues. Implementation of CPOE with a maximum surgical blood order schedule and ERBI led to a substantial decline in blood product dispensed from coolers and reduced returns of unused red blood cells (from 30% to 15%) and plasma units (from 45% to 30%) to the blood bank over 2 years.

DISCUSSION: Electronic PPID, CPOE, and ERBI improved patient safety, workflow, and efficiency during blood transfusions.