Monitoring transfusionist practices: a strategy for improving transfusion safety

Shulman, Ira A.; Lohr, Kristine M.; Derdiarian, AK; Picukaric, JM

doi:10.1046/j.1537-2995.1994.34194098595.x

Cited by 60 publications

(26 citation statements)

References 5 publications

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“…Autologous blood products and the PABD procedure itself are subject to similar conditions as the homologous blood transfusion procedure: As analyzed in retrospective analyses [4][5][6][7], ABO-incompatible autologous transfusions due to clerical errors, occur in 1:5,000 to 1:31,000 transfusions. This rate of human errors is comparable to the mix-up rate found retrospectively in transfusion of homologous blood products (reviews in [8][9][10]). Transfusion to the wrong patient is therefore deemed likely to be the most important transfusion risk nowadays [9].…”

Section: Assumption 2: Pabd Prevents Transmission Of Viruses Via Bloosupporting

confidence: 66%

Do We Still Need Preoperative Autologous Blood Donation? – It Is High Time for a Reappraisal!

Müller¹,

Seifried²

2006

Transfus Med Hemother

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Preoperative autologous blood donation (PABD) can be an adequate solution to a patient’s problem before nonurgent surgery if a high (>10%) probability of perioperative blood transfusion exists in this individual case and, at the same time, pre-existing alloimmunization or a different ethnic background make it difficult to supply this patient with compatible red blood cell concentrates. In times of acute shortness of blood, when nonurgent surgery might be rescheduled and delayed, and in cases of extreme angst-ridden patients fearing homologous blood transfusion, PABD can be considered in rare individual cases as well. Nonetheless, in all these cases, the patient must be eligible for PABD, and the indication as well as potential contraindications have to weighted against each other in a thorough individual risk-benefit analysis. However, these are relatively rare cases. Apart from these and few other situations, PABD in our opinion should not be used because of high costs and logistic efforts, high wastage, considerable risks for the donor/patient on the one hand and miniscule benefits on the other hand. PABD cannot significantly contribute to the blood supply. PABD in error-free use, which is unrealistic, reduces the risk of transmission of known and unknown viral pathogens, but possibly not of bacteria. In real life situations, the residual risk for transmission of transfusion-relevant viruses such as HIV, HVC or HBV is not diminished by PABD. The same is true for clerical errors and ABO incompatibility or acute hemolytic transfusion reactions due to a mix-up of products. PABD reduces the risk of (allo)immunization and therefore has its indication in special clinical situations. PABD on the other hand increases the risks for the donor at the time of donation and afterwards. Autologous blood products seem to have higher rates of bacterial contamination. The risk for the patient to receive any transfusion perioperatively is increased due to the lower hemoglobin levels at admission (iatrogenic anemia) as well as due to a wrongly more liberal transfusion strategy in autologous hemotherapy compared to transfusion of homologous blood. A significant number of patients, who would never receive any transfusion perioperatively at all, enter the transfusion chain due to PABD procedures, facing the risks of a blood donor as well as the risks of a transfusion recipient.

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Section: Assumption 2: Pabd Prevents Transmission Of Viruses Via Bloosupporting

confidence: 66%

Do We Still Need Preoperative Autologous Blood Donation? – It Is High Time for a Reappraisal!

Müller¹,

Seifried²

2006

Transfus Med Hemother

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“…Audit has been used to increase com pliance with procedures for bedside administration of blood products [27,28]. Shulman et al [27] found a high 50% noncompliance rate with blood administration policies in an initial audit. With feedback, education and repeat audits, the noncompliance rate fell to nearly zero.…”

Section: Audit Of Blood Administrationmentioning

confidence: 99%

Audit and Education in Transfusion Medicine

Toy¹

1996

Vox Sanguinis

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Because transfusions carry risks to the patient and because inappropriate transfusions are costly, interest in audits and effective education in transfusion medicine has increased over the last decade. Audits identify areas of practice that can be improved by follow-up education of the physicians who prescribe the transfusions. Successful educational approaches to follow-up on problems identified by audit include 30-min one-on-one meetings with surgeons, traditional scheduled teaching conferences, daily clinical rounds on transfused patients, prospective review of blood transfusions and installation of transfusion practice algorithms in the operating room. Other than identifying inappropriate transfusions, audit and education have also been used successfully to improve bedside blood administration practices, decrease unnecessary crossmatches and reduce outdating of donor blood. Multi-institutional audits play a useful benchmarking role. In summary, audit followed by targeted education can improve practices in transfusion medicine.

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“…Numerous studies have described patient misidentification detected by bedside control [1,10], and/or wristband check [2,11,12]. However, less attention has been given to identification errors involving namesake, i.e., name similarity issues [13,14], and impersonation, i.e., fraudulent identity documents.…”

Section: Introductionmentioning

confidence: 99%

Unreliable patient identification warrants ABO typing at admission to check existing records before transfusion

Ferrera-Tourenc

Lassale

Chiaroni

et al. 2015

Transfusion Clinique et Biologique

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Monitoring transfusionist practices: a strategy for improving transfusion safety

Abstract: The QA/QI process described in this report, or one similar to it, could improve transfusion safety and serve as a model for increased involvement by transfusion service medical directors in the oversight of transfusionists' practices.

Cited by 60 publications

References 5 publications

Do We Still Need Preoperative Autologous Blood Donation? – It Is High Time for a Reappraisal!

Do We Still Need Preoperative Autologous Blood Donation? – It Is High Time for a Reappraisal!

Audit and Education in Transfusion Medicine

Unreliable patient identification warrants ABO typing at admission to check existing records before transfusion

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