Improving quality of care for patients with iron deficiency anemia presenting to the emergency department

Abstract

Improved RBC transfusion appropriateness for IDA in the ED can be achieved and maintained with the implementation of simple educational and practical interventions.

Variations in RBC and frozen plasma utilization rates across 62 Ontario community hospitals

“…A previous study argued that successful institution of QI measures depends on its uptake at the level of the local medical advisory committee to ensure that the overall “culture” of the hospital supports a restrictive transfusion strategy . Physician input and “buy‐in” is another important determinant of the success of a QI intervention . Future studies directed at characterizing physician attitudes with regard to transfusion practices may allow for targeted education to promote the appropriate use of blood products.…”

How do I manage long‐term blood component shortages in a hospital transfusion service?

“…Non‐oncology patients are usually the most relevant population for iron‐replacement therapy. Managing iron deficiency anemia in the outpatient setting with iron plus/minus red cells has previously been described in detail 14 . Other hematinics, such as folate and vitamin B12, should also be considered for correctable deficiencies.…”

Choosing Wisely® in Hematology: Have We Made a Difference?

“…A study that aimed to increase the use of IV iron instead of packed red blood cell (pRBC) transfusions for patients with iron deficiency anemia presenting to the Emergency Department (ED) incorporated multiple interventions to facilitate adopting the use of IV iron instead of pRBC [14]. These interventions included an education session presenting the rationale, introducing IV ferumoxytol, which can be infused over 15 min, developing an algorithm for the ED, and access to a transfusion medicine specialist for guidance when needed.…”

“…These interventions included an education session presenting the rationale, introducing IV ferumoxytol, which can be infused over 15 min, developing an algorithm for the ED, and access to a transfusion medicine specialist for guidance when needed. The end result led to 50% increase in the utilization of what was considered appropriate pRBC transfusions, with a corresponding increase in IV ferumoxytol use for patients who, before the interventions, would have otherwise received pRBC transfusions [14].…”