Blood Transfusion Practice before and after Implementation of Type and Screen Protocol in Emergency Department of a University Affiliated Hospital in Iran

Alavi-Moghaddam, Mostafa; Bardeh, M; Alimohammadi, Hossein; Emami, Habib; Hosseini-Zijoud, Seyed-Mostafa

doi:10.1155/2014/316463

Cited by 19 publications

(19 citation statements)

References 6 publications

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“…This leads to increased waste, larger inventories, and increased departmental costs. 4,9,12,13 Other variables must be considered to effectively assess the need for crossmatching units to a patient and include: preoperative hemoglobin level, predicted blood loss, patient blood volume and likelihood of transfusion 5,6,9,12,13 These variables should all be used in conjunction to evaluate patient needs.…”

Section: Discussionmentioning

confidence: 99%

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Impacts of Updated Transfusion Guidelines on a Small Hospital Blood Bank in a Chicago Suburb

Frelitz

2016

Clin Lab Sci

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The purpose of this research was to identify effective means to utilize blood product resources within a hospital laboratory. A retrospective review of six years of blood utilization data (2010)(2011)(2012)(2013)(2014)(2015) was analyzed from Rush Oak Park Hospital, Oak Park, IL, a small hospital blood bank in a suburb of Chicago. Time-frames included: before electronic medical record (EMR) use: after EMR implementation and computerized provider order entry (CPOE) use: and following targeted physician education. Updated transfusion indications were implemented in time-frame three in an effort to reduce unnecessary crossmatch and transfusion orders, and improve patient safety. The mean number of crossmatched and transfused units decreased significantly from time-frame two to three: from 236±44 units crossmatched to 166±29 units (p <0.001) and 154±31 units to 99±18 units transfused (p<0.001). The blood type and antibody screen (T/S) samples increased significantly over the same period (p<0.03). Surgical and emergency room (ER) crossmatch to transfusion ratios (C:T) showed no significant change, while the other category (inpatient, outpatient, and Hematology/Oncology clinic) revealed a significant increase over time-frames two to three (p<0.001). The number of red blood cell (RBC) units transfused from 2013 to 2014 declined by 646 units, with an estimated cost savings of $129,200. Providing evidence-based guidelines with CPOE to reduce ordering and preparation of blood products is an area of opportunity to improve care and reduce costs. ABBREVIATIONS: EMR -electronic medical record; CPOE = computerized provider order entry; MSBOSmaximum surgical blood order schedule; T/S -blood type and antibody screen; ER -emergency room; C:Tcrossmatch to transfusion ratio; RBC -red blood cell; ANOVA -analysis of variance INDEX TERMS: Blood grouping/crossmatching, erythrocyte transfusion/utilization, cost-savings Clin Lab Sci 2016;29(1):16-20

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Section: Discussionmentioning

confidence: 99%

“…This is a widely accepted method to monitor product use, a 2.0 benchmark is generally considered appropriate. 8,13,14 Apparent in a United Kingdom study, Mundy et al 9 concluded that 77% of total hip and 62% of total knee surgeries requested units which were never used.…”

Section: Introductionmentioning

confidence: 99%

Impacts of Updated Transfusion Guidelines on a Small Hospital Blood Bank in a Chicago Suburb

Frelitz

2016

Clin Lab Sci

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“…The screening and identification of red blood cell (RBC) alloantibodies is performed as pre-transfusion testing (Type and Screen) and in pregnancy to detect potential hemolytic disease of the fetus and newborn (HDFN). A low ionic strength solution (LISS) indirect antiglobulin test (IAT) is considered the most suitable for the detection of clinically significant antibodies because of its speed, sensitivity and specificity [1,2]. According to several international guidelines (such as BSH (British Society for Haematology) and CBO ('Centraal Begeleidingsorgaan') [3], the screening cell set must answer to certain requirements such as the inclusion of at least one cell with homozygous expression of the Fy a , Fy b (Duffy antigens), Jk a , Jk b (Kidd antigens), S and s antigens (MNSs antigens) and heterozygous expression for the K (Kell) antigen [4,5].…”

Section: Introductionmentioning

confidence: 99%

A comparison of three column agglutination tests for red blood cell alloantibody identification

2020

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Objective: Commercial kits of column tests for pre-transfusion testing have progressively replaced conventional tube tests in most laboratories. Aim of this study was to compare three commercial test cell panels for the identification of irregular red blood cell (RBC) alloantibodies. Overall, 44 samples with a positive indirect antiglobulin test (IAT) by routine testing were used for comparison of following panels: Ortho RESOLVE ® panelC (Ortho Clinical Diagnostics (OCD), Milan, Italy), ID-DiaPanel(-P) (Bio-Rad Laboratories, CA, USA) and Identisera Diana(P) (Grifols, Barcelona, Spain). Column agglutination techniques were used, with microtubes containing either microgel (Bio-Rad/Grifols) or glass bead microparticles (Ortho). Results: Alloantibody identification was possible in 38 samples, of which identical identification was shown in 33 samples by all methods. The remaining samples showed differences between certain methods, with the gel card system being superior to the glass card system for analyzing stored samples Considering that not all samples were evaluated in all three methods, the concordance rate reached 100% between Bio-Rad and Grifols, 90.5% between Bio-Rad and OCD, 86.5% between OCD and Grifols and 90.5% between all methods. Although differences in sensitivities were seen for specific antibodies, the three methods showed comparable performance for the identification of RBC alloantibodies.

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“…The Type and Screen (T&S) is a reliable alternative for the management of these situations [1,2]. The T&S includes typing the patient's RBCs for ABO and Rh blood groups, and screening patient's serum for the presence of alloantibodies.…”

Section: Introductionmentioning

confidence: 99%

“…Nowadays, procedures for blood product release according to the T&S and electronic XM have been adopted in several European countries, and their implementation has been advocated by the Italian transfusion regulation as well [5]. Actually, the adoption of T&S procedure and electronic XM in selected patient populations support the rational allocation of blood resources [1,2,4]. …”

Section: Introductionmentioning

confidence: 99%

Red Cell Alloantibody Screening: Comparative Analysis of Three Different Technologies

Orlando¹,

Bianchi²,

Valentini³

et al. 2018

Transfus Med Hemother

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Background: The detection of irregular antibody is a critical issue in the management of red blood cell transfusion according to the Type & Screen (T&S) practice. In order to implement the T&S procedure at our blood bank, we compared three different automated analyzers based on column agglutination technique (CAT) or solid phase red cell adherence assay (SPACA) methods. Methods: Pre-transfusion antibody screening was performed in 986 patients candidate to elective surgery at low risk for red blood cell transfusion. We tested the following kits: the three-cell panel micro-CAT system ID-DiaCell I-II-III (DiaMed), the four-cell panel solid-phase system Capture-R Ready Screen-4 (Immucor), and the four-cell panel micro-CAT system Serascan Diana-4 (Grifols). Positive results were further investigated using corresponding identification panels, and discrepant results were investigated with all the antibody identification systems. Results: Among 986 samples, we observed 967 concordant negative results (98.1%), 8 concordant positive results (0.8% of cases), and 11 discrepant results (1.1%). Among discrepant samples, an alloantibody could been identified in two patents (anti-M, detected by Serascan Diana-4 and ID-DiaCell I, II, III; anti-Kp^a, detected by Capture-R Ready Screen-4 and Serascan Diana-4). Conclusion: Among the evaluated technologies, the four-cell panel micro-CAT system displayed the highest sensitivity and specificity with an optimal negative predictive value. These features might be relevant to the routine implementation of the T&S transfusion strategy.

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Blood Transfusion Practice before and after Implementation of Type and Screen Protocol in Emergency Department of a University Affiliated Hospital in Iran

Cited by 19 publications

References 6 publications

Impacts of Updated Transfusion Guidelines on a Small Hospital Blood Bank in a Chicago Suburb

Impacts of Updated Transfusion Guidelines on a Small Hospital Blood Bank in a Chicago Suburb

A comparison of three column agglutination tests for red blood cell alloantibody identification

Red Cell Alloantibody Screening: Comparative Analysis of Three Different Technologies

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