Prospective monitoring of plasma and platelet transfusions in a large teaching hospital results in significant cost reduction

Abstract

Prospective triage and evidence-based transfusion practice education reduced unnecessary plasma and PLT transfusions and health care costs.

Impacto da implantação de um protocolo de transfusão de hemocomponentes em um hospital terciário do Sul do Brasil através de ferramenta de prescrição eletrônica

“…Especialmente no Brasil e no âmbito do financiamento público do sistema de saúde, mecanismos dirigidos a esse objetivo podem se tornar cada vez mais importantes. (14,15,26) O estudo em questão foi capaz de mostrar que uma intervenção relativamente simples, como a informatização da prescrição do sangue e hemocomponentes, pode mudar de maneira significativa a prática transfusional de uma instituição.…”

Latar Belakang Penyakit pada Penggunaan Transfusi Komponen Darah pada Anak

“…1,9 Masih ditemukan banyak sekali variasi dalam hal indikasi transfusi baik pada trombosit maupun sel darah merah, untuk itu diperlukan penelitian prospektif tersamar untuk menghasilkan petunjuk berbasis bukti. 4,10,11 Pada studi kami terlihat kasus ITP mempunyai rasio kebutuhan tertinggi, yaitu setiap kasus terindikasi transfusi rata-rata memerlukan trombosit 14,7 unit. Hal ini memerlukan telaah lebih lanjut, salah satunya dengan mengevaluasi ulang riwayat indikasi dilakukannya tranfusi TC pada ITP kasus demi kasus.…”

“…Edukasi berbasis bukti akan sangat mengurangi transfusi TC dan menekan biaya perawatan. 11,12 Penyediaan produk untuk transfusi trombosit memerlukan sumber logistik yang baik dan mempertimbangkan faktor biaya. Kesulitan menjaga ketersediaan TC membutuhkan usaha untuk mencari banyak donor.…”

Is there a “magic” hemoglobin number? Clinical decision support promoting restrictive blood transfusion practices

“…Marques et al [63] showed decreased RBC units and percentage of patients transfused through a combination of education and audits [63]. Sarode et al [65] was able to reduce inappropriate plasma usage by 60% and platelet usage by 25% after hospital wide education and prospective monitoring by laboratory staff and housestaff. While concurrent review of each product upon request can be successful, it is very labor intensive, difficult to sustain long-term, and can delay delivery of blood products.…”

“…Review strategies concurrent with physician ordering have been described for RBC [63] as well as for plasma and platelet products [62,64,65]. Marques et al [63] showed decreased RBC units and percentage of patients transfused through a combination of education and audits [63].…”