Bridging the Gaps: A Prospective Analysis of Root Causes for Rejection and Incompleteness in Blood Requisition Forms - 04/09/24

Doi : 10.1016/j.tracli.2024.08.005

Shweta Ranjan ^{^{1
INSTITUTION: Department of Transfusion Medicine and Blood Bank, All India Institute of Medical Sciences, Phulwari Sharif, Patna-801507}} , Nishith Nayan ^{^{1
INSTITUTION: Department of Transfusion Medicine and Blood Bank, All India Institute of Medical Sciences, Phulwari Sharif, Patna-801507}} , Bankim Das ^{^{1
INSTITUTION: Department of Transfusion Medicine and Blood Bank, All India Institute of Medical Sciences, Phulwari Sharif, Patna-801507}} , Rakesh Kumar ^{^{1
INSTITUTION: Department of Transfusion Medicine and Blood Bank, All India Institute of Medical Sciences, Phulwari Sharif, Patna-801507},}^⁎ , Saurabh Lahare ^{^{1
INSTITUTION: Department of Transfusion Medicine and Blood Bank, All India Institute of Medical Sciences, Phulwari Sharif, Patna-801507}} , Neha Singh ^{^{1
INSTITUTION: Department of Transfusion Medicine and Blood Bank, All India Institute of Medical Sciences, Phulwari Sharif, Patna-801507}} , Ruchi Sinha ^{^{1
INSTITUTION: Department of Transfusion Medicine and Blood Bank, All India Institute of Medical Sciences, Phulwari Sharif, Patna-801507}}
Department of Transfusion Medicine and Blood Bank, All India Institute of Medical Sciences, Phulwari Sharif, Patna 801507

^⁎Corresponding author at: Department of Transfusion Medicine and Blood Bank, All India Institute of Medical Sciences, Phulwari Sharif, Patna 801507Department of Transfusion Medicine and Blood BankAll India Institute of Medical SciencesPhulwari SharifPatna801507

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Highlights:

•	This study focuses on identification of the problems that might be involved in incomplete and inaccurate filling of blood requisition forms (BRFs).
•	A detailed root cause analysis of factors leading to incompleteness as well as rejection of BRFs has been done.
•	This study highlights the importance of audits and regular training for ensuring safe blood transfusion process.

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Abstract

Introduction

Blood request form (BRF) stands as a pivotal document in ensuring safe and effective blood transfusions within healthcare settings. Incomplete or erroneous data on BRF can heighten risk of adverse reactions and compromise patient safety. Aim of study was to assess level of completion of BRFs by clinicians and to evaluate root cause analysis (RCA) of incompleteness of BRFs and factors leading to their rejection.

Materials and Methods

This prospective study was carried out from February 2024 to April 2024 on BRFs received in the blood centre. They were audited and RCA for factors leading to their incompleteness and rejection were analysed.

Results

Total number of BRFs received in blood centre was 14,468. 13,358 (92.3%) BRFs were accepted and 1,110 (7.7%) BRFs were rejected. 12,804 (95.85%) of accepted BRFs were incomplete. Weight was the most common missing parameter (89% {n=11403}) while name of the requesting clinician was least common (2.5% {n-318}). 3.52% (n=510) BRFs were rejected due to mismatch in name and patient registration number on BRF and samples. 0.14% (n=21) BRFs were rejected due to hemolysed samples. RCA for incompleteness of BRFs showed that main reason was manpower (61%-83%) while environment was least common (17%-67%). RCA for rejection of BRFs showed that environment was most common cause (13.3%-80.15%) while manpower was least common (9%-19.85%).

Conclusion

Regular audits and personnel training, and quality assurance measures can help identify and address deficiencies in BRF completion to enhance patient safety and reduce incidence of transfusion-related errors and complications.

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Keywords : Blood Requisition Forms, Audit, Incomplete BRFs, Rejection of BRFs, Root Cause Analysis