Blood Transfusion Practices in a Tertiary Referral Intensive Care Unit: A Clinical Audit and Performance Improvement Project

Anemia is common among critically ill patients, despite guidelines recommendations for restrictive transfusion practices, blood transfusion continues beyond recommended triggers. Frequency of blood transfusion in ICU calls for auditing of practices. Method: Two audit cycles a month each, separated by interventional period, audit standards were order issuing personnel, documentation of trigger, trigger according to policy, checking of received unit documentation, monitoring during transfusion, and reporting of adverse events. Results: Standards of trigger documentation, trigger according to policy, and checking documentation were very low in the first cycle, but showed significant improvement in the second cycle, after the performance improvement project. The transfusion rate was significantly lower in the second cycle (18.8/100 patient days vs 14.8 /100 patient days; p = 0.04). Conclusion: Blood transfusion practices remain unsatisfactory in several aspects, however, they could be improved by quality performance improvement projects. Key words: Blood transfusion, intensive care unit, ICU, clinical audit, performance improvement project.