Audit of clinical use of blood products in a tertiary care hospital

Abstract

Objectives: Blood and its components are an important part of patient management treatment protocols and like drugs have property to cause adverse reactions in the recipients. To maximize the effectiveness, safety and utility clinicians and intravenous therapists should be knowledgeable about the potential risk of blood component therapy. Hence, regular audit of blood and its component usage is essential to access the blood utilization pattern and set ideal policies in all the blood using specialties. Material and Methods: This is a prospective Study conducted in department of Transfusion Medicine at Vinayaka Mission Kirupananda Variyar Medical College & Hospital for a period of one year. Source of data was blood bank requisition forms and blood bank registers of patients who underwent elective or emergency procedures in the hospital, for which blood was ordered. Results: The mean age of the study subjects was 41.8 years. The male : female ratio was 1.6 : 1. Majority of the study subjects were in the surgery department followed by Ortho and OBG. Majority of the study subjects belong to B+ve blood group followed by O+ve group and only 20% of the subjects belong to negative blood group. 70% of the subjects required blood transfusion for some kind of surgical intervention and only 28% had required blood transfusion related to medical causes. Majority required four units of PRC transfusion. Majority of the subjects had the haemoglobin levels in the range of 6–7 and the mean level was 6.56 gms%. Majority of the packed red cell was stored for 2 weeks or 5 weeks and the mean duration of storage was 4.3 weeks. A statistical significant improvement was observed in the mean haemoglobin levels in the post-transfusion period compared to the pre-transfusion haemoglobin. Only 5% of the times the reaction related to fever or anaphylaxis had occurred among the entire study subjects. 50% had completed the entire blood transfusion in less than 4 hrs and the mean duration was 4.3 hrs. 65.9% of the patients had appropriate blood transfusion based on the guideline and the remaining 34% had inappropriate blood transfusion. It is inferred from the table that the CTR, transfusion probability and the transfusion index was found to be above the guideline value to be considered as effective blood utilisation. Conclusion: Regular audit of blood components is crucial so that appropriate measures can be taken for proper usage. Continuous medical education regarding the transfusion services for the clinicians and staff nurses have major role in improvement for the clinical transfusion practices in the hospitals.