EP1824386A1

EP1824386A1 - Blood transfusion checking system

Info

Publication number: EP1824386A1
Application number: EP05816001A
Authority: EP
Inventors: Jonathan Wallis
Original assignee: Newcastle Upon Tyne Hospitals National Health Service Trust; Newcastle Upon Tyne Hospitals NHS Trust
Current assignee: Newcastle Upon Tyne Hospitals National Health Service Trust; Newcastle Upon Tyne Hospitals NHS Trust
Priority date: 2004-12-02
Filing date: 2005-12-01
Publication date: 2007-08-29
Also published as: GB0426465D0; WO2006059156A1; GB2420893A

Abstract

A system for matching blood information with transfusion information prior to a blood transfusion. The system includes a portable hand-held device including code recognition means, printing means, and programmed computer means for comparing unique codes contained within first and second identifier means.

Description

Blood Transfusion Checking System

Field of the Invention

The invention relates to a system for matching blood information with transfusion information prior to a blood transfusion, and in particular to a method and device for ensuring that records are only printed by the device when a successful test result is obtained.

Background of the Invention

When carrying out a blood transfusion it is vital that the blood to be transfused is compatible with the blood of the patient. Cross matching of blood to be transfused is generally carried out in the hospital blood laboratory. Tests are carried out to check compatibility and to prevent serious adverse reactions occurring during a transfusion. Once these tests have been carried out, the appropriate blood is issued to medical staff for transfusion to a particular patient.

At the bedside, patient information on the blood-bag should be checked against identification on the patient, usually on a wristband, and if the details match then the transfusion is performed. These checks are usually carried out manually, by eye, and are susceptible to human error, especially if checks are not carried out at the patient's bedside and are made against patient notes instead of wristband identification.

The repercussions of transfusing the wrong patient with the wrong blood can be serious and possibly fatal. In 2003 the Serious Hazards of Transfusion (SHOT) scheme received

358 reports of incidents in the United Kingdom in which incorrect blood components were transfused, resulting in one possible transfusion related death and sixteen cases of major morbidity. The most common error reported was failure to carry out a pre- transfusion bedside check.

Automated systems for tracking and checking patient identity are known.

The I-TRAC system from Immucor provides a system which uses bar coded labels to identify and track blood samples, and to ensure matching data between a patient and blood prior to a blood transfusion. The system relies on the electronic transfer of information around the hospital. The device may produce a printed record for patient notes by electronic transfer of information to a portable printer.

The Safe Track system from Olympus Datalog provides a similar system for producing and matching bar codes relating to data obtained from a remote central database.

US4,835,372 describes a patient identification system which matches bar coded items such as drugs or blood samples to a patient's bar coded wristband. Portable bar code reading devices transmit information to a central database and which performs checks to ensure that the item scanned corresponds to the patient scanned.

JP2001170174 describes a blood transfusion checking system whereby patient wristbands are scanned and checked against information relating to the intended patient and blood preparation information retrieved from a central database.

These known systems are complex in nature and rely on wireless network connections to a central database of patient information and network connections between hospital departments. Such systems are very expensive to implement and can be unreliable due to their reliance on the hospital network.

The present invention offers a system that mitigates the above-identified problems. Summary of the Invention

One aspect of the invention provides a system for matching blood information with transfusion information prior to a blood transfusion as specified in Claim 1.

A further aspect of the invention provides apparatus for implementing the system of the invention as specified in Claim 13.

A further aspect of the invention provides a method for checking that blood information matches transfusion information as specified in Claim 16.

The system and method of the invention is intended to reduce risk of incorrect blood transfusion by providing a simpler system for automating manual checks, and forcing pre- transfusion checks to be carried out at the patient's bedside.

Brief Description of the Drawings

In the drawings, which illustrate preferred embodiments of the invention:

Figure 1 is an illustration of a patient identification wristband with patient identifier code;

Figure 2 is an illustration of a compatibility label with identifier codes attached to a blood-bag;

Figure 3 is a perspective view of a code scanning device;

Figure 4 is a perspective view of a code scanning device with compatibility label inserted; and

Figure 5 is an illustration of a compatibility label complete with printed test results. Detailed Description of the Preferred Embodiments

With reference to figure 1, on admittance to hospital each patient is issued with an identification wristband (1) to be worn around the wrist at all times. The information on the wristband includes the patient's unique hospital identification code (2) along with a machine readable code (3) which represents their patient-unique code along with a further indicator code which is unique to wristbands. In the example shown, the machine readable code is a one-dimensional bar code and the letter W is used as a prefix for all wristband bar codes. For example, if the patient's unique identification code is 1234567 A, the bar code on the wristband represents the characters W1234567A.

With reference to figure 2, in the hospital blood laboratory, appropriate blood is selected for the patient and a compatibility label (4) is produced for that particular blood-bag (5). Information on the compatibility label identifies the patient to which the blood is intended to be administered. This information includes a machine readable code (6) which represents the intended patient's unique hospital identification code along with a further indicator code which is unique to compatibility labels. In the example shown, the machine readable patient identification code (6) is a one-dimensional bar code and the letter B is used as a prefix for all compatibility label bar codes. For example, if the intended patient's identification code is 1234567A, the bar code on the compatibility label represents the characters B1234567A. The compatibility label is securely fastened to the blood-bag.

All staff members in the hospital are also allocated an identification code which is represented by a machine readable code on their hospital identification cards.

The labelled blood-bag is delivered to the appropriate ward. On the ward a portable code scanning device is used to scan the machine readable codes in order to check the identity of the patient and the blood prior to a blood transfusion. A code scanning device is illustrated in Figure 3. The device comprises a portable, handheld box (8), with a screen (9) for delivering instructions to the user, and a slot (10) suitable for inserting a compatibility label. The device also comprises means for printing onto the compatibility label, and a chip programmed with software for recognising machine readable codes. A hand-held code scanner (11) is connected to the device. In an alternative embodiment the code scanner may be integral to the device. The device is powered by a rechargeable battery.

At the patient's bedside the nurse or other suitably qualified member of medical staff switches on the device and then a message on the screen instructs them to insert the compatibility label into the slot. The label (4), which remains attached to the blood-bag (5), is then inserted into the slot (10). Figure 4 illustrates the device with compatibility label inserted. A motor mechanism within the device draws the end of the label into the device. If the label has been inserted correctly the screen will then display a message instructing the user to scan their staff identification code. For example the message "SCAN STAFF ID" may be displayed on the screen (9) of the device. The staff identification code is then scanned using the hand-held scanner (11).

In order to proceed, the scanned staff code must be of an acceptable staff identification code format. This code format will differ from that of wristband and blood-bag code formats. If the scanned staff code does not match the acceptable staff identification format, an error message will be displayed and the user will be prompted to re-scan a staff identification code.

If the scanned staff code is acceptable, a message on-screen will then instruct the user to scan the patient identification code (6) on the compatibility label. For example the message "SCAN LABEL ID" may be displayed on the screen of the device. The label code remains visible to the user when the label is inserted into the device.

In order to proceed, the scanned label code must be in acceptable compatibility label format, i.e. it must comprise a patient identification code plus a standard compatibility label identifier code. In the example given, the label bar code must represent a patient identification code with a letter 'B' prefix. If the label code scanned does not match the compatibility label format for patient identification codes, an error message will be displayed and the user will be prompted to re-scan a compatibility label code.

If the scanned label code is acceptable, a message will then instruct the user to scan the wristband code (3). For example the message "SCAN WRISTBAND ID" may be displayed on the screen of the device. The patient's wristband is now scanned.

In order to proceed, the scanned wristband code must be in acceptable wristband format, i.e. it must comprise a patient identification code plus a standard wristband identifier code. In the example given, the wristband bar code must represent a patient identification code with a letter ⁴W' prefix. If the code scanned does not match the wristband code format, an error message will be displayed and the user will be prompted to re-scan a wristband code.

This procedure prevents a compatibility label code, or a wristband code being scanned twice which would provide a false positive identity check.

Providing that all scanned codes are of acceptable format, the software within the device checks the identity of the patient identification codes contained within the compatibility label code and the wristband code. If both patient-unique codes are identical, the test is successful and the screen will display a message to this effect. For example the message "TEST PASSED" may be displayed on the screen of the device. The device will then print a record onto the bottom portion of the compatibility label contained within the device. A printed compatibility label is illustrated in figure 5. The printed record (12) includes the test result, the patient's identification code, the relevant staff identification code, and date and time information. The label is then ejected from the device. The bottom portion of the label (13) is a self-adhesive sticker that is then peeled away from the label and attached to the patient's records. A record is also printed onto a non-removable part of the compatibility label (14), this enables the compatibility label to be returned to the blood laboratory as a form of receipt. After standard verbal and visual checks and necessary observations have been made the blood transfusion is commenced.

If the patient-unique codes contained within the compatibility label patient identification code and the wristband code are not identical, the test is unsuccessful. An error message will be displayed on the screen and the compatibility label is ejected from the device without a printed record.

The system of the invention requires wristband codes to be scanned, and forces pre- transfusion checks to be carried out at the bedside of the patient. It also requires a positive identity test result in order to produce the printed record for the patient notes.

The compatibility label also carries information about the blood donor, specifically the donation number of the donor, which is a donor-unique code. On the compatibility label, a machine readable code (7, Figure 2) represents the donor-unique code along with a differentiating element which is specific to compatibility label donor codes. The blood bag also carries the donation number of the blood. A machine readable code on the blood bag represents the donor-unique code along with a different differentiating element which is specific to blood bags. The code scanning device described above with reference to Figures 3 and 4 is programmed appropriately to distinguish between blood- bag donor codes and compatibility label donor codes. A blood-bag donor code is scanned and a compatibility label donor code is scanned. If the donor-unique codes contained within the compatibility label donor code and the blood-bag donor code are identical, the test is successful. If the test is successful, a confirmatory message (15, Figure 5) is printed on the compatibility label. This procedure ensures that the compatibility label is attached to the correct blood-bag.

The invention provides a simple and reliable procedure for matching blood information and transfusion information, and device for use in the procedure, that does not rely on obtaining information from a central database.

Claims

1. A system for matching blood information with transfusion information prior to a blood transfusion, comprising:

(a) first code identifier means including a unique code;

(b) second code identifier means including a unique code and a differentiating element;

(c) code recognition means;

(d) programmed computer means for comparing first and second code identifier means and identifying identical unique codes; and

(e) printing means for generating a record

wherein the programmed computer means and printing means are contained a single hand-held device and the code recognition means is connected to the device.

2. A system as claimed in Claim 1, wherein code recognition means is integral to the device.

3. A system as claimed in Claim 1 or 2, wherein first code identifier means includes a differentiating element.

4. A system as claimed in any preceding claim, wherein code identifier means comprises a one-dimensional bar code or a two-dimensional bar code or a coded magnetic strip.

5. A system as claimed in Claim 1, wherein the unique codes are patient-unique codes; the first code identifier means is attachable to a patient for identification of the patient; and the second code identifier means is attachable to a blood-bag for identification of the patient to which blood is intended to be transfused.

6. A system as claimed in Claim 5, wherein the first code identifier means is situated on a patient identification wristband.

7. A system as claimed in Claim 5 or 6, wherein the second code identifier means is situated on a compatibility label securely attachable to a blood-bag.

8. A system as claimed in Claim 1, wherein the unique codes are donor-unique codes; the first code identifier means is attached to a blood-bag; and wherein the second code identifier means is attached to a compatibility label securely attachable to a blood-bag.

9. A system as claimed in Claim 1, wherein the hand-held device comprises slot means for insertion of a compatibility label.

10. A system as claimed in any of claims 7 to 9, wherein a record is printed directly onto the compatibility label.

11. A system as claimed in Claim 10, wherein part of the printed patient record is printed onto a removable portion of a compatibility label for transfer to patient notes.

12. A system as claimed in any preceding claim, wherein first and second code identifier means are machine readable code identifier means.

13. Apparatus for implementing the system of Claims 1 to 12 comprising code recognition means; a printer; a display; and programmed computer means for comparing first code identifier means and second code identifier means and identifying identical unique codes contained within those identifier codes.

14. Apparatus as claimed in Claim 13 comprising slot means for insertion of a compatibility label into the printer contained within the apparatus.

15. Apparatus as claimed in Claim 13 or 14, wherein first and second code identifier means are machine readable code identifier means and code recognition means comprises a code scanner.

16. A method for checking that blood information matches transfusion information comprising the steps of:

(a) inserting the compatibility label into the slot in the hand-held apparatus as claimed in any of Claims 13 to 15;

(b) scanning first code identifier means;

(c) scanning second code identifier means; and

(d) printing a record onto the compatibility label if first and second code identifier means contain identical unique codes.

17. A method as claimed in Claim 16, wherein the unique code is a patient-unique code.

18. A method as claimed in Claim 16 wherein the unique code is a donor-unique code.

19. A method as claimed in any of Claims 16 to 18, comprising the additional step of scanning the staff identification code of the user.

20. A method as claimed in any of Claims 16 or 19, wherein the user is led through the procedure by instructions on the screen of the device.

21. A blood transfusion checking system substantially as shown in and described with reference to the drawings.