Electronic recording of transfusion-related patient observations: A comparison of two bedside systems

Journal article

Background and Objectives

Vital sign observations should be monitored before, during and after transfusion to enable adverse events to be identified, but surveys in the UK show poor compliance with good practice. At the Oxford University Hospitals, there are two electronic bedside processes for recording observations; BloodTrack Tx (Haemonetics Corp.), the routine electronic transfusion process, and a locally developed process, the System for Electronic Nursing Documentation (SEND) with integrated ‘track and trigger’ calculation for monitoring vital signs. The purpose of this study was to evaluate the conduct of patient observation monitoring for blood transfusion using two electronic bedside processes.

Materials and Methods

This study examined the observations recorded during 200 single red cell unit transfusions.

Results

186/200 (93%) transfusions had pre-transfusion observations recorded using BloodTrack Tx. Mid-transfusion checks were performed during 133/200 (67%) of transfusions, out of these checks most (87/200 (44%)) were documented as ‘no apparent change’ in observations. End transfusion observations were performed using BloodTrack Tx in 178/200 (89%). Both systems were frequently used, and staff had a preference for using SEND first for documenting the pre- transfusion observations (102/116 (88%)) and at the end of a transfusion (75/115 (65%)).

Conclusion

Electronic bedside systems result in improved monitoring of transfusion related observations compared to manual processes based on data from UK surveys. There is increasing use of electronic systems in clinical practice; linkage between these two systems would prevent wasteful duplication of observations and could provide improved early warning of adverse events to transfusion compared to manual processes.

Authors: Staples, S; Noel, S; Watkinson, P; Murphy, M

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Wiley
• Journal: Vox Sanguinis
• Volume: 112
• Issue: 8
• Pages: 780–787
• Publication date: 2017-09-27
• Acceptance date: 2017-07-15
• DOI: 10.1111/vox.12569
• EISSN: 1423-0410
• ISSN: 0042-9007
• Keywords: bedside electronic transfusion system; transfusion reaction; observations; vital signs; track and trigger