Transfusion Medicine - Prevention of Bedside Errors

NCT ID: NCT00127556

Last Updated: 2008-05-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

300 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-04-30

Study Completion Date

2005-12-31

Brief Summary

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This study concerns the safety of blood transfusion. Prior to transfusion, staff should perform a number of essential safety checks to ensure that the correct patient is receiving the correct blood product. Evidence suggests that these safety checks are not always done. This study has been designed to assess the effect of a simple intervention on the performance of the bedside safety check.

The hypothesis is that a simple intervention will improve the performance of the bedside check.

Detailed Description

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The local collaborator at each participating hospital will identify two clinical areas comparable for the following elements: similar hours of service, similar use of red cells, similar level of intensity, and similar nurse-to-patient staffing ratios. For the purposes of this study, a clinical area is defined as a discrete area where one type of clinical care takes place. Comparability will be established by completion of a checklist.

The local collaborator will transmit comparability data to the study co-ordinator who will pass it on to a nominated medical consultant (Professor Mike Murphy) and the study statistician. If both parties are satisfied that the two clinical areas are comparable, confirmation will be transmitted to the local collaborator together with authority to commence the two-week baseline audit. Once the baseline is complete the local collaborator will contact the statistician, via the co-ordinator, to be informed of the area for intervention. The local collaborator will then inform the blood bank of the intervention area.

The intervention will be applied to one clinical area or ward in each participating hospital. Both clinical areas will be audited during a two-week baseline observation period. The two areas will then be randomly allocated to either the intervention of labeled blood bags or no intervention. Auditing will carry on in both areas until 2 weeks after the intervention has been introduced. To assess the longer-term impact of the intervention, there will be a further two-week period of audit 8 weeks from the start of the intervention. The intervention will be carried out for the full 10-week period.

The randomized comparison will be based on the data collected in the 2-week period after one area has received the labeled bags, and both areas have been observed by an observer for the same length of time. Thus the effect of the intervention will be separated from any initial effect that the observer may have on bedside checking practice. This comparison will also be made on the long-term audit data collected at 8-weeks.

The intervention under investigation is a simple label applied to the blood bag in such a way to cover (obstruct entry) the "ports" used to administer blood. The label will be applied to units of crossmatched red cells only. The position of the label will require that the user remove the label to administer the red cells. The label will state: "STOP: Check the patient's wristband". The wording will be translated to the appropriate language as necessary.

Observers (auditors)- not blinded to the test or control areas - will be asked to audit the bedside check at the time of transfusion. This will be done by direct observation. The auditor will take up a position to observe practice and will therefore be obvious to the staff. However the auditor will not participate in the transfusion check, not answer questions, and not reveal observed errors in the check (unless they observe that the wrong blood will be transfused, in which case they should intervene). Observations will be recorded on the data form.

Participants are invited from Europe, North America, South America, Asia and Australia. The target is for at least 15 hospitals.

Conditions

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Blood Transfusion

Keywords

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Transfusion Safety

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Blinding Strategy

NONE

Interventions

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Label applied to blood bag

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Crossmatched red cells

Exclusion Criteria

* Uncrossmatched red cells, platelets, fresh frozen plasma
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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BEST research collaborative

UNKNOWN

Sponsor Role collaborator

Dartmouth-Hitchcock Medical Center

OTHER

Sponsor Role lead

Principal Investigators

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Walter Dzik, MD

Role: PRINCIPAL_INVESTIGATOR

Massachusetts General Hospital, USA

Mike F Murphy, FRCPath, MD

Role: PRINCIPAL_INVESTIGATOR

National Blood Service, England

Locations

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LA County and USC Medical Centre

Los Angeles, California, United States

Site Status

Massachusetts General Hospital

Boston, Massachusetts, United States

Site Status

Beth Israel Deaconess Medical Centre

Boston, Massachusetts, United States

Site Status

Dartmouth-Hitchcock Medical Centre

Lebanon, New Hampshire, United States

Site Status

Cincinnati Children's Hospital Medical Centre

Cincinnati, Ohio, United States

Site Status

University Hospitals of Cleveland

Cleveland, Ohio, United States

Site Status

Royal North Shore Hospital

St Leonards, New South Wales, Australia

Site Status

Hospital Sirio Libanes Blood Bank

São Paulo, , Brazil

Site Status

Hamilton Health Sciences

Hamilton, Ontario, Canada

Site Status

Sunnybrook & Women's Hospital

Toronto, Ontario, Canada

Site Status

Haukeland University Hospital

Bergen, , Norway

Site Status

Great Ormond Street

London, , United Kingdom

Site Status

Countries

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United States Australia Brazil Canada Norway United Kingdom

References

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Murphy MF, Casbard AC, Ballard S, Shulman IA, Heddle N, Aubuchon JP, Wendel S, Thomson A, Hervig T, Downes K, Carey PM, Dzik WH; BEST Research Collaborative. Prevention of bedside errors in transfusion medicine (PROBE-TM) study: a cluster-randomized, matched-paired clinical areas trial of a simple intervention to reduce errors in the pretransfusion bedside check. Transfusion. 2007 May;47(5):771-80. doi: 10.1111/j.1537-2995.2007.01189.x.

Reference Type BACKGROUND
PMID: 17465940 (View on PubMed)

Related Links

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Other Identifiers

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TM-PROBE study

Identifier Type: -

Identifier Source: org_study_id