Blood Ordering Habits for Elective Surgery: Time for Change

Juma, Talib; Baraka, Ahmad; Abu-Lisan, M; Asfar, Sami

doi:10.1177/014107689008300610

Cited by 12 publications

(21 citation statements)

References 11 publications

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“…There has been concerns from doctors in our hospital as well as in different parts of the world [5, 7, 8] that excessive ordering of blood can lead to an unintentional misuse of blood bank services. It appears that physicians order cross-matched blood on the basis of habit or as part of hospital routines and there is a tendency in most emergency medical departments to order more units of blood than what are actually needed.…”

Section: Introductionmentioning

confidence: 99%

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

Alavi-Moghaddam

Bardeh

Alimohammadi

et al. 2014

Emergency Medicine International

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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/T ratio), and transfusion index (TI) were checked. C/T ratio 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.

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Section: Introductionmentioning

confidence: 99%

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

Alavi-Moghaddam

Bardeh

Alimohammadi

et al. 2014

Emergency Medicine International

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“…This practice changed when several studies demonstrated minimal blood product use during the perioperative period, concluding that blood group and save (GS) instead of cross-matching was a safe practice with considerable economic benefit [9][10][11][12][13][14], with the former recommended by the British Committee for Standards in Haematology [15].…”

Section: Introductionmentioning

confidence: 99%

Are blood group and save samples needed for cholecystectomy?

Quinn

Suttie

et al. 2011

Surg Endosc

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“…But if it is the theoretical ideal of 1:1, then none did. This suggests that, as has been shown by others, 1,[3][4][5][6][7][8][9][10][11][12][13][14] there is room for improvement in efficiency of our clinicians' blood ordering habits. However, to support concrete proposals, an evaluator must provide more and better particulars in terms of blood actually consumed for specific operations (Table 2).…”

Section: Discussionmentioning

confidence: 90%

“…There is adequate evidence that preoperative antibody screening ("type and hold") combined with selective ordering with an abbreviated crossmatch is safe and cost effective. 1,3,4,[7][8][9][10][11][12][13][14] But, will it find acceptance with clinicians? As pointed out by Dodsworth and Dudley, 1 among others, and indeed as is self-evident, the success of any blood transfusion policy will depend heavily on clinicians' cooperation.…”

Section: Discussionmentioning

confidence: 99%

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Use of Blood in Elective Surgery: An Area of Wasted Hospital Resource

Sowayan¹

1994

Annals of Saudi Medicine

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Unavailability of blood is a common cause of canceled operations but clinicians' blood ordering habits have been shown to waste hospital resources. A prospective audit was set up in a blood bank in a teaching hospital in Saudi Arabia. Data were separately logged on blood transfusion for all surgical operations between August 1991 and December 1992. Standard terminology was employed. During the 16 months, 565 consecutive operations were logged. Only two of eight departments met the criterion of efficient blood ordering, vis-a-vis a C:T ratio (units crossmatched divided by units transfused) of 2.5:1. Similarly, in the four most frequently performed operations, the transfusion index (Ti) was <0.25, indicating that blood would have been required for <25% of these cases. The study confirms others' experience of inefficiency in blood ordering for surgical operations, plus its attendant waste of resources. It is recommended that unless written and binding guidelines are published on a nationwide basis, clinicians' inefficient methods in ordering blood are unlikely to alter rapidly. Ann Saudi Med 1994;14(4):326-328. Resource. 1994; 14(4): 326-328 Since the introduction of blood transfusion into clinical practice, its appropriate use has been a subject for debate. Dodsworth and Dudley 1 reported that only 30% of the blood crossmatched for routine surgery was used and that many operations were being canceled, an event that the government of the United Kingdom now intends to use as an indicator of a hospital's performance. In a recent study from Saudi Arabia, Magbool et al. SA. Sowayan, Use of Blood in Elective Surgery: an Area of Wasted Hospital2 found that canceled operations were frequent and unavailability of blood was the third most common cause.However, surgeons' blood ordering habits are such that supplies, reagents, and technicians' time are committed and can be wasted. Thus, it has been shown from the United Kingdom, 1,3-6 the United States of America, [7][8][9][10] Australia, 11 Kuwait,12,13 and Saudi Arabia 14 that if clinicians' blood ordering habits were rationed, savings would accrue without patients being harmed. For example, Al-Momen et al.14 estimated that an annual savings of 312,000 Saudi Riyals (approximately US $83,000) would accrue in one hospital alone if its blood transfusion services were appropriately used. They concluded, "We are not making the most efficient use of blood bank facilities", and added, "it is most unlikely that we are alone in this regard and we urge . . . other hospitals to review their current blood ordering policies".The purpose of this audit was to determine the efficiency of our surgeons' use of blood transfusions with particular reference to common operations for which blood is routinely ordered. We intend to use the information as a basis for revising our policies on blood ordering for surgical procedures. We also have reason to believe that our findings will be of general interest. Patients and MethodsA prospective survey was conducted in the King Fahd Hospital of the Un...

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Blood Ordering Habits for Elective Surgery: Time for Change

Cited by 12 publications

References 11 publications

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

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

Are blood group and save samples needed for cholecystectomy?

Use of Blood in Elective Surgery: An Area of Wasted Hospital Resource

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