Year: 2018
Type: article
Abstract: transfusion.The objective was to reduce the incidence of blood transfusion by having the clinician reconsider the need for blood transfusion.METHODS: An alert was created that would appear in the electronic ordering system at our two hospitals.This alert asked the clinician if the patient qualified for a transfusion with one or more of the following criteria: hemoglobin less than 7, hemoglobin less than 8 with acute cardiac ischemia, significant hemorrhage, or other.The alert could be bypassed, but the clinician had to pick one of those reasons (a free text reason had to be typed if other was chosen).No clinician or blood bank representative was appointed to check the electronic medical record to ensure that one of the above criteria was met.This was inserted into the system in 2012.Red blood cell unit transfusion prior to and following implementation of the alert was then examined.RESULTS: Prior to the alert, surgical patients received 136.7 units of RBC per 1,000 patient days in 2011.This decreased to 115.3 units by 2013 (-15.6%).Transfusion rates continued to decrease through 2016, where 96.3 units were transfused, a 29.5% decrease since the alerts went into place.When taking all patients at both hospitals into account, the units of blood transfused per 1,000 patient days went from 85.7 in 2011 to 74.2 in 2013 (-13.4 %) to 65.7 in 2016 (-23.3 % from 2011).CONCLUSIONS: Blood transfusion carries significant morbidity for patients.Placement of a clinical alert in the electronic ordering system drastically decreased the rate of blood transfusions.More work can be done in this area to decrease the overuse of blood transfusions.
Source: The Journal of Urology
Language: English
Subfield: Biochemistry
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2795839258