Blood utilization: fostering an effective hospital transfusion culture

Sherman, Carolyn Hyatt; MacIvor, Duncan C.

doi:10.1016/j.jclinane.2011.06.020

Cited by 17 publications

(8 citation statements)

References 80 publications

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“…The primary outcome was compliance with the BSH national guidelines [4]. Secondary outcomes were compliance with in-house policies for G and S tests and cross-matching of blood for elective surgery and also to investigate any cost savings with an updated transfusion policy.…”

Section: Methodsmentioning

confidence: 99%

“…Worldwide, the introduction of evidence-based transfusion guidelines and strategies for improved blood utilisation has been shown to be cost effective and safe. Strategies include timely and adequate preoperative assessment of risk, optimised baseline haemoglobin, intraoperative techniques to minimise blood loss and transfusion-guided targeted therapy [2,3,4]. Frequently, regular audits are required to ensure a balance of supply and demand based on institutional variation secondary to patient and surgeon differences.…”

Section: Introductionmentioning

confidence: 99%

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Blood Transfusion Policies in Elective General Surgery: How to Optimise Cross-Match-to-Transfusion Ratios

Hall

Pattenden

Hollobone

et al. 2013

Transfus Med Hemother

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Objective: Preoperative over-ordering of blood is common and leads to the wastage of blood bank resources. The preoperative blood ordering and transfusion practices for common elective general surgical procedures were evaluated in our university hospital to formulate a maximum surgical blood order schedule (MSBOS) for those procedures where a cross-match appears necessary. Methods: We evaluated blood ordering practices retrospectively in all elective general surgical procedures in our institution over a 6-month period. Cross-match-to-transfusion ratios (C:T) were calculated and compared to current trust and the British Society of Haematology (BSH) guidelines. The adjusted C:T ratio was also calculated and was defined as the C:T ratio when only cross-matched blood used intraoperatively was included in the calculation. Results: 541 patients were identified during the 6-month period. There were 314 minor and 227 major surgeries carried out. 99.6% (n = 226) of the patients who underwent major surgery and 95.5% (n = 300) of the patients having minor surgery had at least a group and save (G and S) test preoperatively. A total of 507 units of blood were cross-matched and 238 units were used. The overall C:T ratio was therefore 2.1:1, which corresponds to a 46.9% red cell usage. There was considerable variation in the C:T ratio, depending on the type of surgery performed. The adjusted C:T ratio varied between 3.75 and 37. Conclusions: Compliance with transfusion policies is poor and over-ordering of blood products commonplace. Implementation of the updated recommended MSBOS and introduction of G and S for eligible surgical procedures is a safe, effective and cost-effective method to prevent preoperative over-ordering of blood in elective general surgery. Savings of GBP 8,596.00 per annum are achievable with the incorporation of updated evidence-based guidelines in our university hospital.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Blood Transfusion Policies in Elective General Surgery: How to Optimise Cross-Match-to-Transfusion Ratios

Hall

Pattenden

Hollobone

et al. 2013

Transfus Med Hemother

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“…The outcomes have been cost effective with no compromise on patient safety. However, the best methodology to evaluate a clinician’s transfusion practice is based on calculating the crossmatch to transfusion ratio (14). Therefore, the more accurate is the prediction of blood loss in a patient by the physician, the lower is the CTR.…”

Section: Discussionmentioning

confidence: 99%

An Analysis of Blood Utilization for Stem Cell Transplant Patients in a Tertiary Care Hospital

Ali

2017

IJSC

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Background and ObjectiveHaematopoietic stem cell transplant is a potentially curative treatment option in various benign and malignant haematological diseases. Patients undergoing stem cell transplant procedure require blood transfusion on a daily basis. Currently, there is paucity of data from developing countries on transfusion practices. This audit was undertaken to determine the consumption of packed red blood cells (PRBCs) transfusion in the bone marrow transplant unit of the Aga Khan University Hospital.Subjects and MethodsA retrospective audit was conducted for packed red cell transfusion ordering practice over a period from June 2014~June 2015. All consecutive patients, admitted for stem cell transplant procedure for various underlying diseases were included. Outcome measures used in this study were (i) cross match to transfusion (C: T) ratio and (ii) transfusion trigger.ResultsDuring the study period, n=25 patients underwent haematopoietic stem cell transplant. There were n=19 males and n=6 females. One patient was less than 15 years of age while rests were adults. Median age±SD was 26.5±14.5 years (12~54 years). The underlying diagnosis included Aplastic anemia (n=8), Thalassemia major (n=3), Multiple Myeloma (n=4), Acute leukemia (n=5), Hodgkin’s lymphoma (n=4), PRCA (n=1). Grand total consumption of PRBCs during the study period was 204 while 258 products were crossmatch. The C:T ratio was 1.26. The transfusion trigger was Hb level of less than 8 gms/dl.ConclusionThe results of our BMT unit indicate that the C:T ratio and transfusion trigger is comparable to the international benchmark.

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“…In the last decade programmes and guidelines for a better use of blood have been introduced in several hospital policies [2][3][4]. Patient Blood Management guidelines (PBM), for example, concern about a correct preoperative transfusion management based on right preoperative identification of anaemic patient, on control of blood loss and coagulopathy during and after operation and on optimisation of anaemia tolerance during the postoperative period [5].…”

Section: Introductionmentioning

confidence: 99%

Blood Use in a Large North Eastern Italian Academic Hospital During the Period 2009-2013: What Reasons for a Decrease?

Quattrin¹

2015

Health Care Current Reviews

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Blood utilization: fostering an effective hospital transfusion culture

Cited by 17 publications

References 80 publications

Blood Transfusion Policies in Elective General Surgery: How to Optimise Cross-Match-to-Transfusion Ratios

Blood Transfusion Policies in Elective General Surgery: How to Optimise Cross-Match-to-Transfusion Ratios

An Analysis of Blood Utilization for Stem Cell Transplant Patients in a Tertiary Care Hospital

Blood Use in a Large North Eastern Italian Academic Hospital During the Period 2009-2013: What Reasons for a Decrease?

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