A Performance Improvement Project for Jehovah's Witness Prenatal Patients [36B

Abstract

INTRODUCTION: Jehovah’s Witnesses (JW) may decline blood products based on religious beliefs. Previous studies have demonstrated that some JW patients may accept blood products during pregnancy. It is important to identify pregnant JW patients and clarify their acceptance of different blood products or alternatives in advance of delivery. This performance improvement project was designed to educate OBGyn providers and create a standardized process to identify JW patients who decline blood products and document their wishes regarding blood products and alternatives. METHODS: A department meeting was held to educate providers and a standard blood product preference form was created. A retrospective chart review of all self-identified JW patients who delivered was conducted to assess for identification in the problem list and standardized documentation of preferences regarding blood products. RESULTS: Between 2013-2014, 24 of 30 (80%) JW patients were identified in the problem list. Fourteen JW patients (46.6%) had further documentation of preferences, however often the information was incomplete. Between January 1, 2015 and June 30, 2016 after the project had been initiated, 9 of 10 JW patients (90%) who had a delivery were identified in the problem list and 7 of 10 patients (70%) had standardized documentation of preferences. CONCLUSION: Education of providers can lead to better identification of JW patients and more comprehensive documentation of their preferences regarding blood products. This workflow could be easily applied to other areas of care, including preoperative management.