1. UNTRUE BLOOD Lily Gonzalez Vicky Yeh

3. Blood transfusions have been around for many years. In 1818, James Blundell, a British obstetrician was the first to perform a successful transfusion of human blood.

4. The first human blood transfusion in the United States (U.S.) was in 1795 given in Philadelphia. Between 1825 and 1830, he performed ten more successful transfusions.

5. In 1926, the British Red Cross was the first blood transfusion service in the world.

8. Twenty nine million units of blood products are transfused each year. Thirty eight thousand units of packed red blood cells are transfused each day.

9. The risk of mistransfusion is at least 100 times greater than the risk of acquiring HIV, Hepatitic C virus ( ).

10. 80 % of blood transfusion errors are shown to be related to either bedside errors and /or labeling errors.

12. Incorrect labeling of blood specimens from the patient at the bedside or during printing of the labels of patients with similar names.

13. Detachment of labels may also result in errors in proper identification.

14. Improper bedside identification may also occur.

15. Other errors include rush situations such as stat orders either in trauma or surgeries.

16. Mix up of blood products may occur during the storage process and during the handling of multiple specimens simultaneously.

17. The most common human error is inadequate cross matching that occurs at the blood bank .

18. According to a study by Sharma et al, 80 percent of blood transfusion errors are shown to be related to either bedside errors and /or labeling errors.

21. 90% of the nurses also answered yes to question #2 regarding mislabeling of blood lab specimens.

22. Reasons can be that many patients have similar last names which can lead to easily confusing the names and picking the wrong addressograph.

23. 50% of nurses stated that they did not do the bedside checks prior to administering.

24. Sadly, bad habits such as these develop due to the familiarity of the patients on a hem/onc unit.

26. The RFID works by placing unique identifier microchips in the forms of stickers on items such as blood bags, patient identification bracelets and any other equipment.

27. RFID tags can be scanned and health information and identification can be accessed. The RFID would virtually eliminate all human errors in the blood transfusion process.

29. According to Fisher and Monahan, “ (RFID) is an emerging technology that is rapidly becoming the standard for hospitals to track inventory, identify patients and manage personnel” (Fisher & Monahan, 2008).

30. The article provides research information that was conducted from May, 2005 to August, 2006 in hospital settings in the Southwestern United States.

31. Data was collected from hospital administrators, technical staff, physicians and nurses.

32. The findings suggest that the RFID system offers great promise for increased efficiency and cost savings.

33. RFID has the potential to provide more efficient processes resulting in saving time and money.

35. The Siemens RF 300 process to be highly flexible and facilitates the manufacture of configurable products. Some of it favorable qualities include being rugged for all production tasks and maintenance free.

36. Fast data transmission between reader/writer and tag (up to 8000 Bytes), and an easy integration in SIMATIC, PROFIBUS and PROFINENT.

37. The Siemens RFID proves to have an especially interference proof data communication with high data security.

38. The RFID system’s hardware include:transponder which is the RFID identification tag that has been programmed with patient information scanning antenna which puts out radiofrequencies which is wireless communication. windows based software that compares data from the wristband to the data stored in the RFID system

39. RFID TYPES

43. Superusers from each unit will go through extensive week long training on the RFID system.

44. Then hospital wide training will begin: 8 hour days of educational training and practice. Educational videos will be shown, hands on training using the RFID system will be provided. Internet tutorials will need to be completed by employees to enforce the teaching of the use of RFIDs.

45. RFID in action

46. The reflection upon our errors gives us wisdom and knowledge that leads to wise, life saving decisions.