Many layers of safety protect patients who receive blood products at Mayo Clinic Hospital — Rochester. For example, electronic controls, like bar codes scanned at the bedside, help ensure the right products are given to the right patients.
Just as important are the safe behaviors of Mayo employees like Amal Adan, Clinical Laboratory Technician of Mayo Clinic's Transfusion Medicine Laboratory.
In a recent near-miss incident, Adan was filling an order for red blood cells when she spotted a notation on the order that stated the patient was immunosuppressed and cytopenic (deficient in certain blood elements). This information wasn’t specified in the usual place on the order (the special needs section) or in the patient’s electronic history.
Adan knew the significance. The patient would need irradiated blood products to prevent transfusion-associated graft-versus-host disease, a potentially devastating condition. Adan called the Transfusion Medicine physician to confirm the special need and then set up irradiated products that were safe for the patient.
“It’s important that, in a culture of safety, everyone can speak up and voice their opinion to make sure that if something is wrong, it can be caught early, so the patient at the other end of the spectrum is getting safe products and the best treatment,” says Adan.
According to Adan, her top five tips for safety in the laboratory include:
1. Pay attention to detail.
For every single sample or order that comes in, we check for accuracy and double-check the patient’s history in the system. The order goes through several checks. The first technician looks at the order when it is received; another person who sets up the order rechecks it. Then, a third person who dispatches the order checks again.
2. Have a questioning and receptive attitude.
I work with a team here that collaborates and asks questions all the time. We are always putting patient’s needs first. We have a system where we can call the patient’s service if we need to, but we also can triage this through a physician.
3. Hand off effectively.
When the shift ends, for the next technician that comes in, we have a handoff card ready with information on what we did, what needs to be finished, and if any unusual things have happened — how the day went. We also talk through these things verbally.
4. Communicate clearly.
Within our work area, we communicate with each other, with a team of IV transfusion nurses that come and get blood from us, with floor nurses and with doctors. It’s a lot of communication, and it has to be clear and accurate. For the nurses, we use the Order Communication System (OCS). For the physicians, we call or page the patient’s service. We consolidate our questions and have one person make the contact.
5. Support each other.
We’re a very teamwork-oriented group. It’s really amazing. If there are massive blood transfusion protocols or if it gets busy, everyone will jump in and help each other to make sure blood products are ready to be taken to the patients in a timely manner.