Proficiency Based Training to Investigate WBIT

NCT03476005 | Completed

• 1 other identifier: #1710
• Study Type: interventional
• Target: 94
• Locations: 1 country
• Sites: 1

Brief Summary

Incorrect labelling of blood samples occurs at a rate of 1% in the general laboratories and 6% in Blood Transfusion Laboratories. The most serious error 'Wrong Blood in Tube' (WBIT) occurs when blood is taken from the intended patient, but labelled with another patient's details. Consequences may include, misinterpretation of a patient's diagnosis or clinical status, incorrect referral or treatment of a patient, or in the worst case scenario, incorrect cross matching for blood of the wrong blood group, which may lead to catastrophic outcomes, including death. The root causes for these errors is failure to identify the patient correctly and failure to correctly label the blood tubes at the bedside. To date, despite significant initiatives, it has proved very difficult to eradicate or reduce the error rate. Our project involves a novel, technology enhanced learning approach using proficiency based progression in a prospective randomised controlled methodology to significantly reduce this error. This approach to learning is more efficient and effective than the traditional approach of repeated practice and is made possible with metric-based simulations. This project will reduce the incidence of adverse events and avoidable medical errors associated with sampling and labelling errors including WBITs. This will be achieved by training healthcare practitioners to a proficiency standard in venepuncture. Thereby minimising the failure of health care professionals to identify the patient correctly and failure to correctly label the blood tubes at the bedside. This project's impact will deliver reduced sampling and labelling errors -including WBITs by a factor of 40-69%. Reductions of this magnitude will have profound national and international implications on how these types of skills are acquired and quality assured. This would result in improved patient safety and savings of over €500,000 at Cork University Hospital and if applied nationally result in exchequer savings of millions of euro annually.

Conditions

Transfusion Related Complication; Wrong Blood in Tube

Outcome Measures

Primary Outcomes (1)

• WBIT

  Wrong blood in tube

  3 months

Secondary Outcomes (5)

• wrong bottle type

  3 months

• under filled samples

  3 months

• clotted samples

  3 months

• haemolysed samples

  3 months

• Mislabelling

  3 months

Study Arms (2)

Proficiently Trained interns -

ACTIVE COMPARATOR

Provided with proficiency based progression training supported by technology enhanced learning

Behavioral: proficiency based progression training

Historical controls

NO INTERVENTION

no extra training provided

Interventions

proficiency based progression training BEHAVIORAL

proficiency based progression training supported by technology enhanced learning

Proficiently Trained interns -

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• All historical interns blood samples from July to Sept 2016 All interns who receive training and working at Cork University Hospital from July to Sept 2017

You may not qualify if:

• Interns in 2017 who do not attend for training

Sponsors & Collaborators

• Patrick Henn: lead

Study Sites (1)

CUH

Cork, Ireland

Location

Study Officials

• Mary Cahill, MD

  UCC

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Lecturer Medical Education

Model Details: Incidence of wrong blood in tube in interns provided with proficiency based progression training supported by technology enhanced learning in 2017 will be compared with historical controls from the same period in 2016

Study Record Dates

• First Submitted: July 5, 2017
• First Posted: March 23, 2018
• Study Start: July 5, 2017
• Primary Completion: July 3, 2018
• Study Completion: July 3, 2018
• Last Updated: July 5, 2018

Record last verified: 2018-07

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, ICF, CSR
• Time Frame: 6 months
• Access Criteria: Determined by principal investigator

Locations

IE (1)