Anyone who works in healthcare or reads a newspaper is aware of the problems plaguing medical providers these days. Overworked staffs, nursing shortages and the restrictions imposed by managed care are just a few factors that have multiplied the burdens of healthcare delivery. If that weren’t enough, reports of medical mistakes have surfaced in the media over the past year, further chipping away the public’s confidence in the U.S. healthcare system. However, the Institute of Medicine’s ‘whistle-blowing’ report in the fall of 1999 has been challenged by at least one scientific group.
Though medical errors are still rare in the grand scheme of healthcare, the reality is that some medical procedures are extraordinarily vulnerable to human error no matter how experienced and competent the caregiver.
Blood specimen collection and transfusions are among these critical procedures, with multiple opportunities for human error and enormous consequences that could result from one mistake — possibly even death. Numerous studies reveal that the process of matching blood products with patients is not foolproof despite multiple checks and safeguards.
I-Trac Plus, a bedside, barcode-driven system from Immucor, is designed to change this. It reduces the risk of ‘mistaken identity’ in the specimen collection and blood administration process by electronically tracking samples and matching them with the correct patients with the scan of a barcode.
Closing the loop
I-Trac Plus benefits all parties involved in the transfusion process — patients, lab professionals and caregivers. The system is managed with a handheld portable data terminal that uses barcode technology to electronically verify transfusion data at the patient’s bedside, scanning the blood product transfusion recipient ID and phlebotomist/transfusionist ID, which also functions as an electronic signature at the time of specimen collection and transfusion. Because a compatibility label and a patient wristband are automatically created as byproducts of the system, users no longer have to deal with problems such as illegible handwriting and incomplete labeling.
When used with an automated blood bank testing system (i.e., Immucor’s ABS2000, ABS Precis/Rosys Plato or the ABS High Volume/Dynex Dias Plus) the I-Trac Plus system closes the transfusion loop by providing accurate identification and tracking of blood products throughout the cycle.
“I-Trac Plus brings some relief to overburdened hospitals,” explained Colin Clark, I-Trac Plus product specialist for Immucor. “The system not only reduces the risk of the wrong product going into the wrong patient, it also enables the process to be carried out by one nurse instead of two, a critical advantage when you’re dealing with staffing shortages.”
Clark also points out that the impending movement toward ISBT 128 — a universal 14-digit barcode language that will replace the standard seven-digit format currently used in the United States — stands to complicate the verification process for nurses using a manual system. “If there’s a propensity for error when a nurse verbalizes seven digits, imagine how much more difficult it would be to accurately verify a 14-digit number,” he noted. “With I-Trac Plus, it’s not an issue.” ISBT 128 officially became standard in the United Kingdom on Dec. 1, 2000; U.S. medical organizations are expected to follow suit within three to four years.
Proven results
Georgetown University Hospital in Washington, D.C., and the IRCCS Ospedale Maggiore in Milan, Italy conducted separate studies of I-Trac Plus to determine the accuracy of the system — and in both evaluations, it performed flawlessly. A total of 621 blood components from 331 blood samples were transfused to 177 patients at both sites. In every instance, all I-Trac Plus functions were 100 percent accurate, from the reading of wristband barcodes to the generation of blood sample labels to the printing of labels for blood components to the positive identification of patients receiving the blood.
“Like other hospitals, we have very specific requirements for the ordering, labeling, initialing and signing of blood for transfusion,” said Gerald Sandler, M.D, the physician at Georgetown who oversaw the I-Trac Plus study. “In our evaluation, 100 percent of all tubes and orders going to the outpatient transfusion service were accepted without modification because I-Trac Plus had generated complete and accurate information. That just doesn’t happen with manual methods where you’re dealing with handwriting and inconsistencies in human performance.” Sandler also noted that I-TracPlus has been a boon for productivity because only one nurse is required to identify the intended recipient and transfuse blood. “They don’t have to find a colleague to verify the match,” he said.
Stay tuned …
The barcode technology used in I-Trac Plus has potential for other applications. “There are opportunities beyond blood transfusions, such as chemotherapy — and in fact all medications that are given to hospital patients,” said Dr. Sandler.
Stephanie Geeter is a freelance writer based in Atlanta.
For more information about I-Trac Plus, contact Immucor, Inc. at 1-800-829-2553 or select Reader Service No. 260 on the reader service card.
