Improving Transfusion Safety Through Enhanced Documentation: An Examination of Organizational Practices in a Tertiary Care Hospital Blood Bank in New Delhi

Abstract

Background:
Blood transfusion is a vital therapeutic intervention, but errors in documentation compromise patient safety. Robust record-keeping and haemovigilance are essential for preventing transfusion-related complications. This study assessed organizational practices, documentation quality, and predictors of transfusion safety in a tertiary care blood bank in New Delhi.

Methods:
A descriptive, observational study was conducted at the Blood Bank of Safdarjung Hospital between January and September 2021. Data were collected through record reviews, structured checklists, and interviews with healthcare staff and transfusion recipients. Statistical analysis included chi-square tests and logistic regression to identify associations and predictors of documentation completeness and adverse reaction reporting.

Results:
A total of 25,050 blood donations and 43,679 component issues were evaluated, along with 31 transfusion reactions and 30 donor adverse events. Documentation completeness was significantly higher among doctors compared to nurses and technicians (p=0.045). Technicians were less likely to complete documentation (AOR=0.42, p=0.030), while haemovigilance-trained staff were over three times more likely to do so (AOR=3.20, p=0.005). Platelet transfusions had a higher rate of adverse reactions compared to RBCs and FFP (p=0.023). Patient satisfaction was greater when risks were explained (p=0.017) and lower among those experiencing adverse reactions (p=0.034). Adverse reaction reporting was more likely among trained staff (AOR=2.70, p=0.030) and during elective transfusions (AOR=1.95, p=0.040).

Conclusion:
Despite strong infrastructure and internal documentation, gaps in staff training, external haemovigilance reporting, and adherence to protocols persist. Structured training, digital reporting, and improved interdepartmental coordination are critical to strengthening transfusion safety.