Enhancing blood transfusion safety through RFID-based verification and human factors engineering.

Introduction: Blood transfusion is a high-risk process, with bedside verification being the last opportunity to intercept potentially fatal errors. This study presents the design, development, and evaluation of an RFID-based system for bedside transfusion verification, grounded in Human Factors Engineering principles. Methods: The system employs passive UHF RFID tags on patients, blood units, and healthcare staff to perform continuous silent verification. When all the needed elements for transfusion (patient, matching blood unit, two healthcare operators) are detected by an active RFID reader and no other possible sources of error are present (e.g., another blood unit or patient nearby), the two operators can proceed with a digital checklist. Completion of the digital checklist by the two operators is enforced before transfusion starts. The system was evaluated in simulated scenarios through a series of technical and procedural tests. The development process was informed by iterative feedback from clinical and technical stakeholders, including nurses, critical care physicians specialized in transfusion medicine, and biomedical engineers. Results: Low detection latency (<300 ms), strong Bluetooth Low Energy stability, sufficient power autonomy (>8 h), and consistent alert behavior under error scenarios were confirmed. Environmental interference from liquids and metal reduced tag readability beyond 130 cm, highlighting positioning and presence of obstacles as a deployment consideration. Discussion: A limitation of the system is that it does not close the loop, i.e., there is no flow sensor that confirms if infusion is taking place and lasts as long as expected. Still, the system presents a significant advantage with respect to existing checklists and barcode-based systems, as it performs passive checks and is silent when no source of error is identified. The proposed RFID-based workflow showed technical feasibility and correct functional behavior in predefined simulated transfusion scenarios, supporting its potential as an additional safety layer to be evaluated in future clinical studies. No real-world clinical testing was performed in this study; therefore, the present work should be interpreted as a pre-clinical proof-of-concept. Future studies should evaluate the system in actual transfusion settings and compare it with current standard verification practices.