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A strategy to reduce inappropriate red blood cell transfusion
Author(s) -
Brandis Kerry,
Richards Brent,
Ghent Anthony,
Weinstein Stephen
Publication year - 1994
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1994.tb125913.x
Subject(s) - medicine , workload , blood transfusion , red blood cell transfusion , patient consent , emergency medicine , medical emergency , intensive care medicine , surgery , computer science , operating system
Objective To evaluate the effectiveness of policies intended to decrease unnecessary packed red cell transfusions. Design and setting The transfusion records of a 550‐bed acute care facility were obtained and two six‐month periods, one before and one after the introduction of new transfusion policies, were compared. Results Meaningful reductions were seen in crossmatch requests, number of units crossmatched and units transfused. After standardising for rising patient numbers, units transfused per 1000 admissions fell by 28.8%. Units crossmatched fell by slightly more than did units transfused, resulting in lower crossmatch‐to‐transfusion ratios, and indicating more effective use of resources. Total requests fell while “group‐and‐screen” requests rose, showing a shift toward more appropriate ordering in the face of increasing workload. Conclusions The transfusion policies have succeeded in curtailing unnecessary transfusion practices. They included the lowering of “transfusion‐triggering” haemoglobin levels, registrar or consultant approval of transfusions and enforcement of patient consent and chart documentation of transfusion indications, verified by the laboratory. The surgical blood ordering schedule was reviewed under the overall direction of the transfusion committee. A strong institutional commitment is required to lift the profile of blood transfusion.