C. Melli* 1, D. Camilot1, D. Cecilia1, M. Medeot1, C. Battaglia1, P. zamaro1, A. Bertolutti1, S. Urban1, S. Pigani1, S. Gallo1, D. A. Vincenzo1
1Transfusion Medicine, Udine University Hospital, UDINE, Italy

Background: Blood component administration represents a critical phase due to the possible occurrence of errors during the different steps from the identification of the patient to the infusion of the product. Error occurence can be reduced by the implementation of validated information systems. We tested the SCWeb® System at the bedside in a transfusion outpatient clinic. Aims: The aim of the study is to validate a system designed to assist and to control blood administration step by step using electronic devices to ensure traceability and documentation of the process
Methods: The SCWeb® System is based on IT monitored checklists which guide the personnel to follow the procedure, according to best practices; the system must initially be activated by the operator which is recognized by an auto-signing system based on Bluetooth Low Energy which avoids the operator having to identify himself/herself beforehand. Appropriate privacy protection is provided. Thereafter the system takes up the task to give instructions and to verify the adherence, by asking an active confirmation of the proper fulfillment of the activities; a continuous registration and documentation is made by the system. Standards and specifications for each step of the procedure have been configured on SCWeb® System to track in detail operator and patient identification, presence of informed consent to transfusion, blood pressure, pulse and temperature recording, vein access, verification of the blood unit. An alarm has been set after 15 minutes, to ensure the control of patient’s conditions. For each step, an active confirmation of the action is required and nurse and doctor direct involvement must be actively confirmed on the device by both operators. The system has been tested at the bedside on 30 patients admitted to the outpatient clinic for 45 red cell concentrate transfusion; compliance of the personnel and organizational impact have been recorded.
Results: The System required a very short training: ease of SCWeb® system allows its implementation without negative impact on organization of transfusion outpatient clinic and without difficulties by operators (nurses and doctors), who appreciated the help given by the IT check system. The registration of the electronic check list offered a reliable tool for the traceability of the transfusion procedure, also granting a paperless and timely available documentation of the entire process through a registration in electronic format of all the operator’s action in every single phase of the transfusion process. When prescribed, confirmation of the checklist was only possible in the presence and with the active confirmation of two operators (doctor and nurse).
Summary / Conclusions: The SCWeb® system can be utilized as a barrier against the mismatch of transfusion (preventive measure), as a traceability and documentation measure and as a tool for training of personnel in blood transfusion administration; interestingly, it avoids paper registration during the transfusion process, due to the timely registration of the activities performed by
operators recognized by the system thanks to the Bluetooth Low Energy auto-signing device. The SCWeb® system will be connected to the transfusion data management system, to monitor all the process from the arrival of the unit from the blood bank.