December 2020

Bloody Easy Blood Administration eLearning

By Donna Berta RN BScN, Clinical Project Coordinator – Nursing, ORBCoN

In keeping with ORBCoN’s goal to inspire and facilitate best transfusion practices in Ontario and the Transfusion Medicine regulatory standards requirement to provide continuing education and competency assessment for transfusionists, the Bloody Easy Blood Administration eLearning tool was created. The regulatory standards include Canadian Standards Association, Standard CSA Z902 – Blood and Blood Components; Canadian Society for Transfusion Medicine, Standards for Hospital Transfusion Services; Accreditation Canada, Standards for Transfusion Services; and Institute for Quality Management in Healthcare, Medical Laboratory Accreditation Requirements.

The Bloody Easy Blood Administration electronic learning tool is under revision (anticipated completion February 2021). The content will be renewed to align with the 2019/2020 standards. The tool is being condensed to a 30-minute program and restructured to focus on patient care priorities to ensure safe transfusion of the most frequently transfused blood component, red blood cells. Additional resources will be available to translate the knowledge and principles to other blood components and blood products. On completion of the program, a quiz is provided (target score for successful achievement is 80 percent) and a certificate can be printed for the participant’s records.

The Bloody Easy Blood Administration eLearning program is available as a web-based program, including a utilization tracking mechanism. A hospital site administrator can be established to document participation and outcomes (scores). For more information about this ORBCoN resource, or to have a site administrator assigned please contact your Regional ORBCoN office.

Bloody Easy Lite-eLearning Program for Physicians

Newly Revised Bloody Easy Lite program has been launched!

By Troy Thompson, Regional Manager, ORBCoN

Accreditation Canada standard 4.3 requires that each hospital have a formal program in place to maintain team members’ competence, including an evaluation of their theoretical and practical knowledge of transfusion medicine. This competency assessment requirement applies to all team members, including prescribing physicians.¹

Bloody Easy Lite is an electronic learning tool providing basic information for physicians and other healthcare professionals who prescribe blood components/products. The learning program consists of 2 modules, both of which include a pre-module knowledge test. Module 1 focuses on the indications for blood transfusion and contains subcategories related to pre-transfusion testing and transfusion of red blood cells, platelets, plasma and fibrinogen replacements. Specifically related to red blood cells, there are sections on transfusion basics, managing acute blood loss and anemia, and transfusion of perioperative patients. The program offers an optional participant tracking mechanism (password protected) to assist health care facilities in meeting competence requirements by providing hospitals with pre-populated participant completion lists. The program is also available in SCORM compliant files for hospitals that use Learning Management Systems (LMS) to house content for their education/training/competency requirements.

A study recently published in CMAJ Open² showed that completion of the Bloody Easy Lite modules was associated with an absolute improvement of 6.8% in appropriate transfusions based on a hemoglobin threshold of 80 g/L. Additionally, transfusion knowledge retention, as evidenced by comparing the standardized pre-test and post-test scores, was greatly improved. The median pre-test score was 50% with the median post-test scores being 90% for module 1 and 80% for module 2.

E-Learning programs such as Bloody Easy Lite provide users with convenient, flexible access to learning content which can be self-driven or self-paced based upon the user’s own level of knowledge, skill or experience, and time constraints.

For more information regarding the Bloody Easy Lite eLearning program please visit https://transfusionontario.org/category/bloody-easy-e-tools-publications/bloody-easy-lite/ or contact your Regional ORBCoN office.

Accreditation Canada. 2018. Qmentum Standards Transfusion Services. Ver.12.
Lee TC, Murray J, McDonald EG. An online educational module on transfusion safety and appropriateness for resident physicians: a controlled before–after quality-improvement study. CMAJ Open 2019. 7(3): 492-96. DOI:10.9778/cmajo.20180211

Massive Hemorrhage Protocol

By Stephanie Cope, Regional Project Coordinator, ORBCoN

In anticipation of the provincial toolkit winter release, we wanted to remind hospitals that we have 5 training modules intended to provide key personnel the information they need when a Massive Hemorrhage Protocol is activated and if/when an overhead ‘code transfusion’ is announced. Find them here.

The educational working group stressed the importance of a multi-faceted approach in the implementation of the provincial statements/recommendations and that not just ONE strategy would be beneficial to hospitals. With this approach in mind, you can look forward to a ‘workbook’ that will also include possible barriers (with solutions) to implementation and change.

In addition, the MHP educational working group is busy creating more helpful resources that include three simulation videos that will depict MHP activation scenarios in pediatrics, trauma and GI from both community and teaching hospital settings. There will be simulation scripts of the three scenarios also available with the objective that they can be used in any simulation modality from tabletop to mannequin depending on the resources available at the hospital level. To accompany the videos an observational teaching tool has been created for hospitals to use as a template to guide attention to certain parts of the scenario and may also be a useful tool for novice debriefers.

We are pleased to provide you with a generic PowerPoint slide deck that can be used to present at (for example) Grand Rounds to orientate your clinicians about the provincial recommendations for massive hemorrhage. Find the slide deck here.

Bloody Easy Tech Assessments (Tech Assess)

By Alison Wendt, Regional Project Coordinator, ORBCoN

One of the strategic goals set by ORBCoN is to improve patient safety and standardize best practices through provision of educational resources to hospital transfusion services in the province.

A number of provincial and national standards cite the need for education and training of all staff involved in the transfusion process. Tech Assess supports hospitals in meeting compliance with these required standards:

CSTM v4.0 April 2017 

2.14  

The TS shall ensure there is a process for an annual competency assessment program for all medical, clinical and support staff involved in any transfusion related activity including the preparation of blood components and blood products for administration. The program shall include:^{4.3.3.1/14.4.2}   a. assessment of theoretical and practical knowledge  
b. additional training where indicated  
c. documentation of all assessment and additional training ^4.3.4

All training, orientation, education and competency shall be documented. ^{4.3.2.1/4.3.4}  

The competency program shall be evaluated at least every two years.

Tech Assess is a competency program which consists of Basic and Advanced level questions intended to provide Medical Laboratory Technologists in Ontario with a mechanism to assess and build on their technical and theoretical Transfusion Medicine knowledge.

The user has access to all tests and correct answers with the rationale for each. Upon successful completion, with a passing grade of 80% for Basic and 60% for Advanced, a certificate is available to print. The user also has a Personal History tab where previous assessment grades and certificates can be downloaded and printed. Site administrators who register the users in eTools have the ability to track staff’s completion of the tests.

The Tech Assess 2020-21 Program tests are currently under development with release date coming soon.

To obtain more information on this ORBCoN resource, or to have a site administrator set up for your facility please contact your Regional ORBCoN office.

References

CSTM/SCTM Standards for Hospital Transfusion Services v4. CSTM.Markham;2017.

CAN/CSA-Z902:20. Blood and Blood Components. Canadian Standards Association. Toronto;2020.