Background For many years, great efforts have been put in place to ensure quality and safety of blood and blood products during collection and processing. In recent years, the focus has shifted to enhancement of clinical transfusion processes. Conducting audits is one effective mechanism of evaluating the ongoing blood administration process against set standards. Methods Random transfusion audits were conducted jointly by both Blood Bank technical staff and the transfusion nurse in Paediatric and Obstetric wards using a checklist. This checklist consisted of essential procedures and checks during blood transfusion. Transfusion slips were also audited against defined standards. Results Many good transfusion practices were observed. In the majority of cases, there was positive identification of patients before transfusion by doctor and nurse. However, there were many areas requiring improvement, including inconsistency in setting up transfusions across different clinical areas in the hospital. Knowledge deficit was identified in eight key areas when results of a transfusion knowledge questionnaire were reviewed. Audit of the transfusion slips revealed a major concern with putting up blood for transfusion within 30 minutes. All findings were reviewed, and interventions were undertaken. A formal transfusion training programme was implemented, and the institution's clinical transfusion protocol was revised for better clarity. Conclusion Initiatives implemented after reviewing all findings from the transfusion audits lead to improved practice, thereby enhancing patients’ safety. Continuous audit will be required to monitor and sustain improvements.
Background: The paediatric massive transfusion protocol (MTP) is activated in the paediatric population for both trauma and non-trauma related indications. While it helps to improve the efficiency and efficacy of the delivery of blood products, it can also result in increased wastage. We aimed to evaluate the wastage rates from our paediatric MTP activations from 2013 to 2018. Method: As part of an audit, we retrospectively reviewed the records of the paediatric patients who had MTP activations. We collected the following data: reason for MTP activation, weight of patient, number of cycles of MTP required, blood products used, blood products wasted, deviation from our institution’s recommended MTP blood product ratio, and reason for wastage. Result: We had 26 paediatric MTP activations within the audit period. There was an overall wastage rate of 1.5%, with wastage occurring in 3 out of 26 patients. The reason for all wastage was demise of the patient. Most patients’ transfusion ratios deviated from our institution’s MTP protocol. Conclusion: Our wastage rates are low likely because of clear MTP activation guidelines and a flexible MTP workflow.
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