Improving transfusion therapy in elective surgery

F. Foieni, G. Introcaso, A. Ratto

Research output: Contribution to journalArticle

Abstract

PURPOSE: in July 1996 we implemented the quality system in our transfusion service and we studied the effect of this implementation on the transfusion practice in elective cardiac surgery. METHOD: we analyzed and compared transfusion data between first and second semester of 1996 in order to evaluate the appropriateness of blood requests (BR), of blood's management in the department, the units transfused with regard of the units assigned, and the safety of the transfusion practices. About the management, we have scheduled how the activities were to be conducted, controlled and recorded (Procedure Manual). Practically we extended the type and screen procedure to all cardiac operations with the exception of the alloirnmunized and recently transfused patients (pts) (last three months). Criteria for BR rejection included: red blood cells: preoperative Hb> 100g/L and estimated blood loss 50x109/L. BR incomplete for relevant clinical or laboratory data was discussed with the physicians and completed. RESULTS: Appropriateness of the blood group typing request (N. and %) Pts with typing request and blood request/pts with blood request 1226/4900 (25) I semester II semester Appropriateness of the blood request RBC FFP RBC FFP Units required urgently/units required 465/3471(13) 340/2907 (12) Units transfused/units required 1048/3471(30) 1096/2907 (38) Requests evaluated 383(100) conforming 303(79) Units expired in departement/ 19/2252 8./1112 18/1151 2/528 units delivered (0.8) (0.7) (1.5) (0.4) Units transfused/units delivered 1048/2252 798/1102 1096/1151 515/528 (46) (72) (98) (92) Identification errors at transfusion 0/1048 0/798 0/1096 0/577 CONCLUSION: the type and screen has improved the rate of units transfused with regard to units assigned (46 to 98) but has moderately increased the units rejected for expiry because this procedure requires a greater number of units stored. The appropriateness of blood request was satisfactory and could be improved by a prospective audit and continuous monitoring. Lack of compliance with good transfusion practice was particulary evident for the blood group typing request.

Original languageEnglish
Pages (from-to)229
Number of pages1
JournalInfusionstherapie und Transfusionsmedizin
Volume24
Issue number4
Publication statusPublished - 1997

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surgery
therapeutics
blood
Blood Grouping and Crossmatching
erythrocytes
Therapeutics
Blood Group Antigens
blood groups
audits
Thoracic Surgery
physicians
compliance
Erythrocytes
Physicians
Safety
monitoring

ASJC Scopus subject areas

  • Food Science
  • Immunology
  • Hematology

Cite this

Improving transfusion therapy in elective surgery. / Foieni, F.; Introcaso, G.; Ratto, A.

In: Infusionstherapie und Transfusionsmedizin, Vol. 24, No. 4, 1997, p. 229.

Research output: Contribution to journalArticle

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abstract = "PURPOSE: in July 1996 we implemented the quality system in our transfusion service and we studied the effect of this implementation on the transfusion practice in elective cardiac surgery. METHOD: we analyzed and compared transfusion data between first and second semester of 1996 in order to evaluate the appropriateness of blood requests (BR), of blood's management in the department, the units transfused with regard of the units assigned, and the safety of the transfusion practices. About the management, we have scheduled how the activities were to be conducted, controlled and recorded (Procedure Manual). Practically we extended the type and screen procedure to all cardiac operations with the exception of the alloirnmunized and recently transfused patients (pts) (last three months). Criteria for BR rejection included: red blood cells: preoperative Hb> 100g/L and estimated blood loss 50x109/L. BR incomplete for relevant clinical or laboratory data was discussed with the physicians and completed. RESULTS: Appropriateness of the blood group typing request (N. and {\%}) Pts with typing request and blood request/pts with blood request 1226/4900 (25) I semester II semester Appropriateness of the blood request RBC FFP RBC FFP Units required urgently/units required 465/3471(13) 340/2907 (12) Units transfused/units required 1048/3471(30) 1096/2907 (38) Requests evaluated 383(100) conforming 303(79) Units expired in departement/ 19/2252 8./1112 18/1151 2/528 units delivered (0.8) (0.7) (1.5) (0.4) Units transfused/units delivered 1048/2252 798/1102 1096/1151 515/528 (46) (72) (98) (92) Identification errors at transfusion 0/1048 0/798 0/1096 0/577 CONCLUSION: the type and screen has improved the rate of units transfused with regard to units assigned (46 to 98) but has moderately increased the units rejected for expiry because this procedure requires a greater number of units stored. The appropriateness of blood request was satisfactory and could be improved by a prospective audit and continuous monitoring. Lack of compliance with good transfusion practice was particulary evident for the blood group typing request.",
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