title: Evaluation of the non-compliance with grouping guidelines which may lead to "wrong blood in tube", an observational study and risk factor analysis.
abstract: BACKGROUND
  In France, blood group determination requires the completion of two samples collected at two different times to detect identity mistake and "wrong blood in tube". The aims of the present study were: (1) to evaluate the compliance with guidelines and (2) to identify risk factors of non-compliance.
  
  
  METHODS
  Samples for ABO group determination collected between January 1st and December 15th, 2013 in the University hospital of Nîmes, France were analyzed. An ABO group determination demand was considered non-compliant if more than one tube arrived in the laboratory within ten minutes apart. Between May 1st and June 30th 2014, a self-administered questionnaire was offered to the nurses of the hospital on a random day for each service during this period. The aim was to validate the non-compliance criterion and the identification of risk factors using logistic regression.
  
  
  RESULTS
  Among the 16,450 analyzed blood samples, the overall compliance rate was 65.1%. Lower compliance rates were found in the surgical services. Independent risk factors for wrong practice were work overload, surgical service and individual intermediate transfusion frequency.
  
  
  CONCLUSIONS
  More than one third of ABO group determinations did not follow national recommendations, which induces a substantial risk of "wrong blood in tube" and group error. The study revealed major variations among hospital services. Identification of risk factors allows targeted corrective actions.
authors.affiliation: Division anesthésie réanimation douleur urgences, CHU de Nîmes, place du Pr Robert-Debré, 30029 Nîmes cedex 9, France. Electronic address: aurelien.daurat@chu-nimes.fr.
authors.forename: A
authors.initials: A
authors.lastname: Daurat
authors.affiliation: Division anesthésie réanimation douleur urgences, CHU de Nîmes, place du Pr Robert-Debré, 30029 Nîmes cedex 9, France.
authors.forename: E
authors.initials: E
authors.lastname: Boudet
authors.affiliation: Hospital hemovigilance officer, délégation qualité gestion des risques, CHU de Nîmes, place du Pr Robert-Debré, 30029 Nîmes cedex 9, France.
authors.forename: G
authors.initials: G
authors.lastname: Daurat
authors.affiliation: Division anesthésie réanimation douleur urgences, CHU de Nîmes, place du Pr Robert-Debré, 30029 Nîmes cedex 9, France.
authors.forename: C
authors.initials: C
authors.lastname: Roger
authors.affiliation: Laboratory of Hematology, CHU de Nîmes, place du Pr Robert-Debré, 30029 Nîmes cedex 9, France.
authors.forename: J-C
authors.initials: JC
authors.lastname: Gris
authors.affiliation: Établissement français du Sang Pyrénées-Méditerranée, site de Nîmes, place du Pr Robert-Debré, 30029 Nîmes cedex 9, France.
authors.forename: V
authors.initials: V
authors.lastname: Tunez
authors.affiliation: Direction of care, CHU de Nîmes, place du Pr Robert-Debré, 30029 Nîmes cedex 9, France.
authors.forename: M-C
authors.initials: MC
authors.lastname: Gaste
authors.affiliation: Division anesthésie réanimation douleur urgences, CHU de Nîmes, place du Pr Robert-Debré, 30029 Nîmes cedex 9, France.
authors.forename: J-Y
authors.initials: JY
authors.lastname: Lefrant
mesh_terms: D001788:Blood Grouping and Crossmatching / Q000592:standards* / Q000706:statistics & numerical data; D001803:Blood Transfusion / Q000592:standards* / Q000706:statistics & numerical data; D005163:Factor Analysis, Statistical; D005602:France; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D019300:Medical Errors / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors
keywords: Adhérence aux recommandations; Détermination de groupe; Group determination; Guidelines compliance; Red blood cell transfusion; Transfusion de globules rouge