Blood Utilization: Audit of Transfusion Practice Using an Electronic Review System.
- Author:
Hyungsuk KIM
1
;
Kyoung Un PARK
;
Kyou Sup HAN
Author Information
1. Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea. kshanmd@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Blood utilization review;
Blood component transfusion;
Medical audit;
Clinical decision support systems
- MeSH:
Birth Rate;
Blood Component Transfusion;
Blood Platelets;
Blood Transfusion;
Decision Support Systems, Clinical;
Electronics;
Electrons;
Erythrocytes;
Gastroenterology;
Humans;
Medical Audit;
Plasma;
Tissue Donors
- From:Korean Journal of Blood Transfusion
2010;21(2):93-104
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Despite the increasing demand for transfusions, the availability of blood is hampered by low birth rate and stringent donor qualifications. Therefore, it is important to appropriately utilize blood products and take measures to minimize their wastage. We established an electronic review system for assessing transfusion practice and evaluated the appropriateness of blood transfusion. METHODS: Utilization of red blood cells (RBC), platelet concentrates (PC), single donor platelets (SDP), fresh-frozen plasma (FFP), and cryoprecipitates issued to 3 major blood using departments (Internal Medicine Divisions of Gastroenterology and Hematology/Medical Oncology, General Surgery) at the Seoul National University Hospital was reviewed over a one-month period. A new program was developed to review laboratory test results and blood product information. Criteria for appropriate transfusion were based on the guidelines proposed in 2009 by the Korean Ministry of Health and Welfare and the Korean Society of Blood Transfusion. A comparative audit was also conducted according to the guidelines proposed in 2002. RESULTS: There were 3,705 units of blood components issued to 325 patients during 1,542 transfusion episodes. The number of inappropriately transfused units were 402 (10.9%) at 144 (9.3%) episodes. The rates of inappropriate transfusion episodes (as per the 2002 guidelines) per blood components were as follows: RBC, 0.4%; PC, 11.7% (8.3%); SDP, 5.7% (2.4%); FFP, 20.2% (2.4%); and cryoprecipitates, 22.1%. CONCLUSION: Based on the 2009 guidelines, there was a notable inappropriate use of blood transfusions. Education programs promoting evidence-based guidelines and the use of this new program will help clinicians make better decisions in transfusion practice and lower inappropriate transfusion rates.
