ISSN 2997-1036
International Journal of Hematology | Vol. 7, No. 8, August 2016 | pp. 57–64
DOI: 10.46882/2016/IJH/000080
Short Communication
Title: Validation of an automated delta check protocol for detecting mislabeled blood transfusion cross-match matrices
Names of Authors: B. C. Akpan¹, D. E. Usman²
Authors’ Affiliations: ¹Department of Haematology, University of Calabar, Calabar, Nigeria; ²Department of Clinical Pharmacology, Ahmadu Bello University, Zaria, Nigeria
Abstract: Pre-analytical specimen labeling errors carry an exceptionally high risk of inducing fatal ABO hemolytic transfusion reactions in blood bank practice. This operational study evaluated the sensitivity and positive predictive value of an automated laboratory information system delta check protocol, utilizing mean corpuscular volume (MCV) and hemoglobin variations, for detecting mislabeled blood transfusion cross-match tubes. Over a 12-month audit window, the delta check flag was triggered in 145 out of 12,400 blood grouping and cross-matching requests. Manual review confirmed a true mislabeling error (wrong blood in tube) in 48.2% (70 of 145) of the flagged samples. The remaining flags were caused by severe acute hemorrhage or massive intra-operative fluid resuscitation. The MCV delta check (variation > 4.5 fl from historical baseline) demonstrated an isolated sensitivity of 92.8% for detecting wrong-patient specimens. Implementing automated multi-parameter delta check systems provides a vital electronic safety filter that alerts laboratory staff to potential specimen mismatches before cross-matching is completed.
Keywords: Blood transfusion safety, delta check, pre-analytical error, mislabeled specimen, laboratory automation
Manuscript Timeline: Received: May 15, 2016; Revised: June 22, 2016; Accepted: July 11, 2016; Published: August 19, 2016