Assessment of Faculty Knowledge Regarding Transfusion Practice

Abstract

APGO Advisor: Nancy Hueppchen, MD PURPOSE: To assess knowledge and transfusion practices among obstetrics and gynecology faculty. BACKGROUND: Blood transfusions are overused, with an estimated expenditure of $14 billion in 2009 and increased morbidity and mortality. Activity-based cost analysis revealed administration of a single unit of blood to surgical patients costs $726–$1,183 in the United States. METHODS: A validated test evaluating transfusion threshold practices of packed red blood cells (PRBCs), knowledge of transfusion cost, and of hospital transfusion protocols was administered to 19 obstetrics and gynecology faculty members before and after a formal presentation on resources involved in the preparation of PRBCs and the hospital transfusion protocol. Subsequently, a retrospective and prospective cohort chart review was performed evaluating 16/19 faculty members' obstetric transfusion practices 5 months before and after the presentation. RESULTS: 36.8% correctly identified the approximate cost to transfuse 1 unit of PRBCs pre–educational presentation and post–educational presentation. (with inclusion of our facility cost, 89.4% answered correctly). 47.3% of the faculty would transfuse a healthy, asymptomatic, non‐bleeding patient at a [Hgb] of 6 g/dL before the educational presentation compared with 36.8% posttest with an increase of 26.3% who would transfuse at 7 g/dL. The percentage of faculty who would initiate a transfusion with only 1 unit of PRBCs increased after the educational presentation (68.4% compared with 84%). The transfusion rate in delivering patients pre–educational presentation and post–educational presentation was unchanged at 1.5%. DISCUSSION: Although the transfusion rate is unchanged, participating practitioners have been educated on the cost to transfuse PRBCs and have visualized our hospitals' transfusion protocol.