Background Blood derived medicines (BDM) require close monitoring because of their theoretical infectious risk. However, clinical teams experience difficulties applying regulations and numerous dysfunctions are identified daily.
Purpose We wished to identify recurrent non-compliances in the circuit of BDM to set up specific and efficient actions to improve this circuit.
Material and methods Non-compliances were identified and collected at each stage of the BDM circuit (from prescription to administration traceability) over an 8 month period (March 2015 to November 2015).
Results Over the study period, 2242 BDM were dispensed and 46 non-compliances were noted. 48% of these non-compliances related to traceability (obligatory elements were missing in 50% of cases, traceability was lost or missing in 32% of cases, and returned too late in 18%). 20% of non-compliances were orders which did not conform to procedures. 19% affected prescriptions (including 55% of redundant prescriptions, 22% dosing error and 22% patient non-identification). 7% of non-compliances were about pharmacy distribution mistakes. 4% related to lost products in care units and 2% of non-compliances were about stock shortage in the pharmacy.
Each time a corrective measure was immediately introduced after contacting the care unit (we searched for the missing information and the administration traceability in the transfusion record, we delivered information documents, and planned visits in the unit to train the clinical team). This process allowed a reduction in the number of non-compliances identified.
Conclusion This work allowed us to identify critical points in the BDM circuit and to set up specific corrective actions. Most of non-compliances affected traceability of the BDM, an essential step in the circuit. Training actions about circuit and management of BDM from prescription to administration have been affected in care services. Information documents have been created to secure each step of the circuit. These improvement measures are currently evaluated.
No conflict of interest
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