Original article

Blood Transfusion - 6 2019 (November-December)

Patient Blood Management: transfusion appropriateness in the post-operative period

Authors

Key words: patient blood management, transfusion therapy, transfusion appropriateness
Publication Date: 2019-07-10

Abstract

Background. Within the context of patient blood management (PBM) policy for the peri-operative period, the transfusion medicine unit of our institution adopted a series of strategies to support and enhance red blood cell (RBC) transfusion best practices. This study aimed to evaluate the appropriateness of RBC transfusion therapy in the post-operative period, before and after starting a multifactorial PBM policy.
Materials and methods. A 2-phase observational study was conducted on patients who underwent major surgery. The study was designed as follows: 3 months of preliminary audit, followed by multifactorial PBM policy, and a final audit. The policy comprised seminars, teaching lessons, periodic consultations and the insertion of Points of Care. RBC transfusion appropriateness was evaluated in both audits.
Results. The preliminary audit, performed on 168 patients, showed that 37.7% of the patients were appropriately transfused. The final audit, performed on 205 patients, indicated a significant increase of RBC transfusion appropriateness to 65.4%.
Discussion. In our experience, our multifactorial PBM policy improved the RBC transfusion appropriateness in the post-operative period. We believe that our multifactorial PBM policy, which comprises the insertion of Points of Care, supported the healthcare workers in the transfusion decision-making process. This enhancement of transfusion appropriateness implies clinical and managerial advantages, such as reduced transfusion-related risks, optimisation of health care resources, and reduction in costs.

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Authors

Erminia Di Bartolomeo - Transfusion Medicine Unit

Lucia Merolle - Transfusion Medicine Unit

Chiara Marraccini - Transfusion Medicine Unit

Laura Canovi - Transfusion Medicine Unit

Pamela Berni - Transfusion Medicine Unit

Monica Guberti - Health Care Professionals Unit

Angela Mazzi - Transfusion Medicine Unit

Alessandro Bonini - Transfusion Medicine Unit

Nicola Romano - Transfusion Medicine Unit

Antonia Magnani - Operations Management Unit, Azienda USL-IRCCS,

Thelma Aguiar Pertinhez - Transfusion Medicine Unit; Department of Medicine and Surgery, University of Parma, Parma, Italy

Roberto Baricchi - Transfusion Medicine Unit

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