The successful example of an interconnected network within the blood transfusion services.
“We’ve been wanting to implement a computerised transfusion record system for years,” recalls Silvana Leo-Kodeli, haemovigilance consultant and head of the Blood transfusion safety and haemovigilance unit at CHR.
“But, so far, the applications of such a record system were limited to only a few services. Our goal was to be able to obtain a global repository that would allow all professionals concerned to access the complete transfusion history of the patient under treatment.” In 2017, as part of a call for tenders, Cursus 3 was selected by the CHR of Orléans, together with Sandrine Dessi from the Digital Services Department (DSD). “It simultaneously met our specifications, the regulations in force and the recommendations of scientific bodies”.
Didier Guyot-Walser, founder and Managing Director of the eponymous company, further clarifies the application’s operational scope, pointing out its interoperability capabilities. It’s effectively connected with the Établissement Français du Sang (EFS – French Blood Establishment), staff directories (to ensure access management), the organisational framework (automation of changes within the hospital’s structure), the admissions department (real-time monitoring of patient movements).
“We’re also connected to the laboratories,” adds Didier Guyot-Walser. “As such, we can rely on laboratory results to ensure the safety of transfusions”.
In the event of a problem, alerts are automatically issued to haemovigilance operators: biological incompatibility results, product temperature breaches, transfusion incidents.
The 1980s were marked by the tainted blood scandal, which still casts a shadow on issues related to transfusion. Since then, however, haemovigilance and all professionals involved in the transfusion chain have continued to make progress. The EFS, the Agence Régionale de Santé (ARS – Regional health agency) and hospitals are now all required to ensure product traceability in order to guarantee that the right blood product has been administered to the right patient. It’s a delicate management process, which the CHR of Orléans has decided to entirely computerise by implementing the Cursus 3 tool, published by Guyot-Walser.
The project team in charge of this implementation included the haemovigilance unit and the DSD, in partnership with Guyot-Walser’s IT team and the EFS-CPL. Throughout 2018, the main stages comprised technical and functional configuration, interaction tests with the EFS and, finally, the launch across pilot care services.
Training workshops for medical and paramedical personnel were held for a week before general deployment in early December.
“The advantage of Cursus 3 is that it encompasses the entire transfusion process, from medical prescription through to the traceability of patient’s consent and the confirmation of transfusion sent to the EFS via a secure digital flow,” emphasises Silvana Leo-Kodeli. “With regard to services, Cursus is accessible via DPI contextual calls, promoting both the use of the tool and user-friendly ease.
The immuno-haematological results, carried out at the EFS, were integrated and made available on Cursus.
Another advantage concerns the possibility of configuring transfusion protocols, either at individual (allergic subjects, transplant recipients, etc.) or at group (pregnant women, elderly people) level.” To date, the prescriptions entered in Cursus must still be printed, signed by the prescriber and sent to the EFS. Regulatory compatibility checks are verified by further computer checks at each stage, from arrival in the department to just before administering the transfusion to the patient.
Throughout the transfusion, a registered nurse can enter the vital parameters in Cursus.
“If an adverse effect of the transfusion occurs, the registered nurse or the doctor will enter it on Cursus, which will automatically alert the haemovigilance unit by email,” explains the doctor.
Regulatory aspects are also complied with, as the system allows printing of the relevant documentation that should be given to the patient after the transfusion (information on the number and type of labile blood products received and post-transfusion irregular antibody screening tests prescribed).
Cursus 3 also allows for the statistical analysis of data, to be used in specific research studies or as part of annual assessments of transfusion activity.
“This tool facilitates the management of traceability and optimises the daily work of the haemovigilance unit,” states Silvana Leo-Kodeli. A tool that, indeed, has further increased safety in this field.