scholarly journals A Review of Blood and Blood Products Requisition and Utilization in Post-neonatal Ward of a Tertiary Hospital in South Western Nigeria

10.46912/56 ◽  
2021 ◽  
Vol 4 (1) ◽  
pp. 97-107
Author(s):  
SO Akodu ◽  
FA Adekanmbi ◽  
TA Ogunlesi
Keyword(s):  
Tertiary Hospital ◽  
Blood Products ◽  
Inappropriate Use ◽  
Ready Availability ◽  
Blood Usage ◽  
Blood Utilization ◽  
The Cross ◽  
Transfusion Ratio ◽  
Cross Match ◽  
Neonatal Ward

Background: Blood and its products ordering is a common practice in paediatrics. The ready availability of blood and blood components has resulted in liberal use. Inappropriate use of blood and blood products exposes patients to the risk of transfusion transmissible diseases and allergic and haemolytic reactions. Objective: To assess blood and blood products requisition and utilization in a post-neonatal ward in a semi-urban tertiary hospital in Nigeria Methods: Retrospective analysis of medical records of all transfused post-neonatal patients during the study period from 1st July 2015 to¬ 31st December 2016 to calculate the cross-match to transfusion ratio, transfusion probability and transfusion index. Results: The units of blood cross-matched were 98 and 90 blood units transfused. The cross-match to transfusion ratio was 1.09 indicative of significant blood usage. The transfusion probability was 100% indicative of significant blood usage. The transfusion index was 1.10 indicative of significant blood utilization. Conclusion: Transfusion of blood and blood products in the post-neonatal ward of our setting meet the standard criteria for quality indicators for blood utilization.

scholarly journals Efficiency of blood utilization in elective surgical patients

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kibruyisfaw Zewdie ◽  
Abraham Genetu ◽  
Yeabsera Mekonnen ◽  
Tewodros Worku ◽  
Abat Sahlu ◽  
...  
Keyword(s):  
Surgical Procedure ◽  
Safety Margin ◽  
Tertiary Hospital ◽  
Surgical Patients ◽  
Cross Sectional ◽  
Patient Will ◽  
Blood Usage ◽  
Elective Surgical Procedure ◽  
Blood Utilization ◽  
Transfusion Ratio

Abstract Background Requesting blood prior to a surgical procedure for perioperative transfusion is a common practice in surgical patients. More unit of blood is requested than used by anticipating the patient will be transfused to provide a safety margin in an event of unexpected haemorrhage. Over requesting with minimal utilization results in significant wastage of blood, reagents and human resource. This study was conducted to assess blood utilization practice of the largest tertiary hospital in Ethiopia. Methods A cross-sectional prospective study method was used. Data was collected using a Proforma questionnaire by perusal of each individual patient’s records from December 1, 2017 to February 28, 2018.patient age, sex, department requesting the blood, level of operating surgeon, hemodynamic status, number of unit requested, number of unit crossed matched and number of unit transfused were collected. Efficiency of blood utilization was calculated with three indices: Crossmatch to transfusion ratio, transfusion probability, and transfusion index indices. Results Blood was requested for 406 patients and a total of 898 units were crossmatched for this patients. Overall Crossmatch to transfusion ration, transfusion probability and transfusion index were 7.6, 15.3% and 0.29 respectively. Results showed insignificant blood usage. Among different departments and units, better blood utilization was seen in neurosurgical unit with C/T ratio, TP and TI of 4.9, 24.4 and 0.6% respectively, while worst indices were from obstetrics unit with C/T ratio, TP and TI of 31.0, 6.5% and 0.06. Conclusion Using all the three parameters for evaluation of efficiency of blood utilization, the practice in our hospital shows ineffective blood utilization in elective surgical procedure. Blood requesting physician should order the minimum blood anticipated to be used as much as possible.

scholarly journals Transfusion Medicine Informatics: Analysis of User Burden from Clinical Decision Support Alerts in Promoting Patient Blood Management

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S123-S124
Author(s):  
H C Tsang ◽  
P Mathias ◽  
N Hoffman ◽  
M B Pagano
Keyword(s):  
Decision Support ◽  
Clinical Decision Support ◽  
Blood Product ◽  
Clinical Decision ◽  
Blood Products ◽  
Blood Management ◽  
Before And After ◽  
Blood Utilization ◽  
Transfusion Ratio ◽  
Major Project

Abstract Introduction/Objective To increase efficiency of blood product ordering and delivery processes and improve appropriateness of orders, a major project to implement clinical decision support (CDS) alerts in the electronic medical record (EMR) was undertaken. A design team was assembled including hospital and laboratory medicine information technology and clinical informatics, transfusion services, nursing and clinical services from medical and surgical specialties. Methods Consensus-derived thresholds in hemoglobin/hematocrit, platelet count, INR, and fibrinogen for red blood cell (RBC), platelet, plasma, and cryoprecipitate blood products CDS alerts were determined. Data from the EMR and laboratory information system were queried from the 12-month period before and after implementation and the data was analyzed. Results During the analysis period, 5813 RBC (avg. monthly = 484), 1040 platelet (avg. monthly = 87), 423 plasma (avg. monthly = 35), and 88 cryoprecipitate (avg. monthly = 7) alerts fired. The average time it took for a user to respond was 5.175 seconds. The total amount of time alerts displayed over 12 months was 5813 seconds (~97 minutes of user time) compared to 56503 blood products transfused. Of active CDS alerts, hemoglobin/RBC alerts fired most often with ~1:5 (31141 RBC units) alert to transfusion ratio and 4% of orders canceled (n=231) when viewing the alert, platelet alerts fired with ~1:15 (15385 platelet units) alert to transfusion ratio and 6% orders canceled (n=66), INR/plasma alerts fired with ~1:21 (8793 plasma units) alert to transfusion ratio and 10% orders canceled (n=41), cryoprecipitate alerts fired with ~1:13 (1184 cryoprecipitate units) alert to transfusion ratio and 10% orders canceled (n=9). Overall monthly blood utilization normalized to 1000 patient discharges did not appear to have statistically significant differences comparing pre- versus post-go-live, except a potentially significant increase in monthly plasma usage at one facility with p = 0.34, although possibly due to an outlier single month of heavy usage. Conclusion Clinical decision support alerts can guide provider ordering with minimal user burden. This resulted in increased safety and quality use of the ordering process, although overall blood utilization did not appear to change significantly.

scholarly journals Blood transfusion practices in a tertiary care hospital in Nepal

2020 ◽  
Vol 10 (2) ◽  
pp. 1728-1732
Author(s):  
Amar Narayan Shrestha ◽  
Barun Babu Aryal ◽  
Ayusha Poudel ◽  
Shraddha Poudel ◽  
Shreya Shrestha ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Tertiary Care ◽  
Transfusion Practice ◽  
Care Hospital ◽  
Good Utilization ◽  
Use Of Resources ◽  
The Cross ◽  
The Individual ◽  
Transfusion Ratio ◽  
Cross Match

Background: Blood transfusion is an integral part of patient management. Good transfusion practice guided by standard protocols is considered ideal for optimal use of resources and manpower. Cross-match requests disproportionate to the actual requirement causes overestimation of blood usage and potential wastage. This study aims to determine the crossmatch, transfusion, and utilization rates for blood using transfusion index, and cross-match to transfusion ratio in the various departments of the hospital for the evaluation of transfusion practices. Materials and Methods: A retrospective study was conducted using the records from the hospital blood bank for 12 months to obtain transfusion and cross-match records from various clinical units. Transfusion requests, units cross-matched, and completed transfusions were used to calculate the cross-match to transfusion ratio, and transfusion index for each department. Results: A total of 5156 units of blood were cross-matched for 3437 transfusion requests, out of which 3752 were transfused, giving a mean cross-match to transfusion ratio of 1.37. The non-usage of blood was 27.2% and the transfusion index stood at 1.09. The cross-match to transfusion ratio for the individual clinical units ranged from 1.75 (Surgery) to 1.14 (Medicine). Conclusions: The cross-match to transfusion ratio and transfusion index were within recommended ranges, showing good utilization and low blood wastage. The establishment of a blood ordering protocol via a multidisciplinary approach should be considered to further optimize blood transfusion practices.

A study of blood cross-matching requirements for surgery in gynecological oncology: Improved efficiency and cost saving

2003 ◽  
Vol 13 (6) ◽  
pp. 889-893 ◽  
Author(s):  
C. L. Foley ◽  
T. Mould ◽  
J. E. Kennedy ◽  
D. P. J. Barton
Keyword(s):  
Prospective Audit ◽  
Tertiary Referral ◽  
Retrospective Case ◽  
Gynecological Oncology ◽  
Tertiary Referral Center ◽  
Transfusion Requirements ◽  
Blood Usage ◽  
Transfusion Ratio ◽  
Cross Matching ◽  
Cross Match

The objective of this study was to design and implement a maximum surgical blood order schedule (MSBOS) within a specialist gynecological oncology department in a tertiary referral center and evaluate its impact on the cross-match to transfusion ratio (CTR). A retrospective case note audit was undertaken to identify common operations performed within the unit and their transfusion requirements. The efficiency of blood usage was assessed using the CTR, and an MSBOS was devised and implemented. A prospective audit of preoperative blood cross-matching and subsequent blood usage was then performed for consecutive elective operations in the unit, to assess the effect of the MSBOS. The retrospective study of 222 cases demonstrated a CTR of 2.25 equivalent to 44% usage of cross-matched blood. Ninety two percent of operations performed within the unit could be incorporated into an MSBOS. The prospective study of 207 cases demonstrated a significantly reduced CTR of 1.71 or 59% blood usage (χ2 = 12.4, P < 0.001). This equates to a saving of 102 units of blood over the 15 months prospective audit. Protocol adherence was 77%. No patient was adversely affected by the adoption of the MSBOS. We conclude that an MSBOS can be safely introduced into a gynecological oncology department resulting in significant financial savings.

scholarly journals Efficiency of blood utilization and characteristics of patients receiving blood transfusion at an associated hospital in North India

2021 ◽  
Vol 9 (4) ◽  
pp. 1056
Author(s):  
Irm Yasmeen ◽  
Ibrar Ahmed ◽  
Shazia Bashir
Keyword(s):  
Blood Transfusion ◽  
Blood Donation ◽  
Cross Sectional Study ◽  
North India ◽  
Periodic Review ◽  
Cross Sectional ◽  
Medical College ◽  
Inappropriate Use ◽  
Blood Utilization ◽  
Transfusion Ratio

Background: Blood is the liquid connective tissue composed of cells and plasma. It is the most precious and unique gift that one person gives to another. Blood banks are not the manufacturing factories. It can only be available on replacement basis. Periodic review of blood components usage is essential to assess the blood utilization pattern in hospitals. This study was conducted to analyse the efficiency of blood utilization and to minimize the inappropriate use of blood.Methods: A retrospective cross-sectional study was conducted in the department of blood transfusion and immunohematology, government medical college and associated hospital, Rajouri for a period of one year with effect from November 2019 to November 2020. Data was collected using blood bank record. Blood utilization was calculated using crossmatch to transfusion ratio (C/T), transfusion probability (T%) and transfusion index (TI) indices.Results: A total of 974 patients were requested to prepare 1270 crossmatched units. Of these 1141 blood units were transfused for 664 patients. The total donations during that period were 1197. 998 donors were replacement donors and 199 were voluntary non-remunerated blood donors donated at various blood donation camps. The overall values of C/T, T% and TI were 1.1:1, 68.1% and 1.1 respectively.Conclusions: Blood utilization indices show efficient usage of blood. However, a blood ordering policy (MSBOS) must be developed to guide the clinicians regarding blood usage which can decrease overordering of blood thereby reducing unnecessary usage of reagents, manpower and also wastage of blood due to outdating. 

scholarly journals Blood utilization in elective surgery in a tertiary hospital in Dar es Salaam, Tanzania

2015 ◽  
Vol 17 (4) ◽  
Author(s):  
Larry O. Akoko ◽  
Alex B. Joseph
Keyword(s):  
Elective Surgery ◽  
Working Hours ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Dar Es Salaam ◽  
Cross Sectional ◽  
The Status ◽  
Blood Utilization ◽  
Cross Match ◽  
Structured Questionnaire

Background: There has been an observation of blood being unnecessarily requested even for surgeries that will not require transfusion. Furthermore, some patients have been denied surgery due to lack of blood causing surgical list disruptions and inconveniency to patients and their families. This study was carried out to determine the status of blood utilization practices at Muhimbili National Hospital (MNH) in Dar es Salaam, Tanzania.Methods: A descriptive cross-sectional study was carried out for a period of eight months. Data on blood requisition and usage was collected on a structured questionnaire, and analyzed for Cross-match to Transfusion (C/T) ratio, Transfusion probability (%T), and Transfusion Index (TI). For those procedures that showed more than two indices to be significant, a Maximum Surgical Blood ordering Schedule MSBOS was proposed.Results: Blood was over ordered for 76% of the patients while over eight percent of the patients had haemoglobin levels over 10g/dl. Only amputation, laparotomy for malignancies, pneumonenctomy, and bowel resection for malignancy had at least two of the transfusion indices showing significant blood utilization for general surgery cases.  For urological cases, only Cystectomy for bladder cancer and nephrectomy had at least two of the indices showing significant blood utilization. In the remaining cases, blood utilization was inefficient suggesting cross-matching of blood was unnecessary, which resulted in loss of nearly 73% of technician’s working hours and USD 425 for the study period.Conclusion: There is existence of over ordering of blood in this hospital. Blood ordering practices needs to be reviewed to minimize over ordering of blood. All the three indices showed inefficient use of blood in most of the operations. But even so, utilization can still be improved in some of the operations which showed significant utilization.

scholarly journals Seeking Strategies to Optimize Blood Utilization: The Preliminary Experience with Implementing a Patient Blood Management Program in a Greek Tertiary Hospital

2021 ◽  
Vol 10 (10) ◽  
pp. 2141
Author(s):  
Aimilia Tsante ◽  
Anastasia Papandreadi ◽  
Andreas G. Tsantes ◽  
Elias Kyriakou ◽  
Panagiota Douramani ◽  
...  
Keyword(s):  
Tertiary Hospital ◽  
Management Program ◽  
Transfusion Practice ◽  
Patient Blood Management ◽  
Medical Patients ◽  
Blood Management ◽  
Transfusion Threshold ◽  
Restrictive Transfusion ◽  
Implementation Period ◽  
Blood Utilization

Objectives: Our aim was to assess blood utilization after implementation of a patient blood management (PBM) program in a Greek tertiary hospital. Methods: An electronic transfusion request form and a prospective audit of transfusion practice were implemented. After the one-year implementation period, a retrospective review was performed to assess transfusion practice in medical patients. Results: Pre-PBM, a total of 9478 RBC units were transfused (mean: 1.75 units per patient) compared with 9289 transfused units (mean: 1.57 units per patient) post-PBM. Regarding the post-PBM period, the mean hemoglobin (Hb) level of the 3099 medical patients without comorbidities transfused was 7.19 ± 0.79 gr/dL. Among them, 2065 (66.6%) had Hb levels >7.0 gr/dL, while 167 (5.3%) had Hb levels >8.0 gr/dL. In addition, 331 (25.3%) of the transfused patients with comorbidities had Hb >8.0 gr/dL. The Hb transfusion thresholds significantly differed across the clinics (p < 0.001), while 21.8% of all medical non-bleeding patients received more than one RBC unit transfusion. Conclusion: A poor adherence with the restrictive transfusion threshold of 7.0 gr/dL was observed. The adoption of a less strict threshold might be a temporary step to allow physicians to become familiar with the program and be informed on the safety and advantages of the restrictive transfusion strategy.

scholarly journals Blood Transfusion Practice before and after Implementation of Type and Screen Protocol in Emergency Department of a University Affiliated Hospital in Iran

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Mostafa Alavi-Moghaddam ◽  
Mahmoud Bardeh ◽  
Hossein Alimohammadi ◽  
Habib Emami ◽  
Seyed-Mostafa Hosseini-Zijoud
Keyword(s):  
Emergency Department ◽  
Blood Transfusion ◽  
Transfusion Practice ◽  
Time Interval ◽  
Blood Transfusions ◽  
Common Diseases ◽  
Before And After ◽  
Transfusion Ratio ◽  
Cross Match

Background. Blood transfusion is the cornerstone of therapy for many serious and common diseases. This study was performed to assess blood transfusion practice before and after implementation of type and screen protocol in emergency department of a university affiliated hospital in Iran, 2012-2013.Methods. An audit was studied before and after the implementation of type and screen protocol. The number of blood transfusions, time interval between blood order and transfusion, cross-match to transfusion ratio (C/Tratio), and transfusion index (TI) were checked.C/Tratio was used as a measure of the efficiency of blood ordering practice. We compared our results before and after implementation of type and screen protocol.Results. In present study after implementation of type and screen protocol, the time interval between requesting blood transfusion and transfusion of blood has decreased significantly (P<0.001). The number of blood transfusions required by actual patients increased significantly from 1/2 to 2 (P<0.001). The average cross-match to transfusion (C/T) ratio got near 1.13 from 1.41 and TI got near 0.91 from 0.58 (P<0.001).Conclusion. The implementation of T&S protocol has been proven to be safe, efficient, and beneficial to the transfusion practice of our hospital from the current study.

Time Is Nephron: Increasing Organ Utilization of Marginal Donors By Foregoing The Cross Match. A Single Center Protocol and Experience.

2014 ◽  
Vol 98 ◽  
pp. 649
Author(s):  
Y. Qazi ◽  
C. Parke ◽  
S. Alexopoulos ◽  
L. Matsuoka ◽  
K. Dhanireddy ◽  
...  
Keyword(s):  
Single Center ◽  
The Cross ◽  
Marginal Donors ◽  
Cross Match

scholarly journals Gaia Data Release 2

2019 ◽  
Vol 621 ◽  
pp. A144 ◽  
Author(s):  
P. M. Marrese ◽  
S. Marinoni ◽  
M. Fabrizio ◽  
G. Altavilla
Keyword(s):  
Global Analysis ◽  
Data Retrieval ◽  
High Accuracy ◽  
Data Archives ◽  
Data Release ◽  
Astronomical Research ◽  
The Cross ◽  
Single Data ◽  
Cross Matching ◽  
Cross Match

Context. Although the Gaia catalogue on its own is a very powerful tool, it is the combination of this high-accuracy archive with other archives that will truly open up amazing possibilities for astronomical research. The advanced interoperation of archives is based on cross-matching, leaving the user with the feeling of working with one single data archive. The data retrieval should work not only across data archives but also across wavelength domains. The first step for a seamless access to the data is the computation of the cross-match between Gaia and external surveys. Aims. We describe the adopted algorithms and results of the pre-computed cross-match of the Gaia Data Release 2 (DR2) catalogue with dense surveys (Pan-STARRS1 DR1, 2MASS, SDSS DR9, GSC 2.3, URAT-1, allWISE, PPMXL, and APASS DR9) and sparse catalogues (HIPPARCOS2, Tycho-2, and RAVE 5). Methods. A new algorithm is developed specifically for sparse catalogues. Improvements and changes with respect to the algorithm adopted for DR1 are described in detail. Results. The outputs of the cross-match are part of the official Gaia DR2 catalogue. The global analysis of the cross-match results is also presented.

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