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

Abstract

Background: Safe blood transfusion depends not only on infrastructure and testing but also on meticulous documentation and effective haemovigilance. Incomplete records and under-reporting of adverse events compromise patient safety and limit system-level learning. Aims & Objectives: To evaluate organizational practices, documentation completeness, and predictors of transfusion safety, including adverse reaction reporting, in a tertiary care hospital blood bank in New Delhi. Methodology: A descriptive observational study was conducted from January to September 2021 at the Blood Bank of Safdarjung Hospital. Record reviews of 25,050 donations and 43,679 component issues were undertaken. Structured assessments of healthcare personnel and analysis of 31 transfusion reactions and 30 donor adverse events were performed. Chi-square tests and logistic regression identified factors associated with documentation completeness and reporting. Results: Documentation completeness was significantly higher among doctors than nurses and technicians (p=0.045). Technicians were less likely to complete records (AOR=0.42, p=0.030), whereas haemovigilance-trained staff were more likely to document accurately (AOR=3.20, p=0.005) and report reactions (AOR=2.70, p=0.030). Platelet transfusions showed higher adverse reaction rates (p=0.023). Patient satisfaction improved when risks were explained (p=0.017). Conclusion: Although infrastructure and internal documentation systems were robust, gaps in staff training, external haemovigilance reporting, and transport practices persist. Structured training, digital reporting integration, and strengthened protocol adherence are essential to enhance transfusion safety.