Extended Follow-up of an Educational Intervention Encouraging Appropriate Use of Blood Transfusions

Abstract

Introduction: A restrictive transfusion strategy of packed red blood cells (PRBCs) has been associated with at least non-inferior patient outcomes in a variety of clinical settings. In December 2014, we conducted an educational intervention which consisted of an oral presentation and computerized notifications at a single tertiary medical center. Objective: The aim of this study was to examine the long-term effects of a simple and low-cost educational intervention aimed to promote awareness to transfusion guidelines. Methods: We retrospectively analyzed all PRBC transfusions ordered between 2014 and 2017. The primary end point was defined as the percentage of PRBC transfused to patients with hemoglobin (Hb) ≥8 g/dL. Results: Between 2014 and 2017, a total of 27,475 PRBCs were transfused in our medical center. There was a continuous reduction in the percentage of PRBCs transfused at a Hb level ≥8 g/dL between 2014 and 2017, with a matching increase in the PRBC percentage trans­fused at Hb <7 g/dL (OR reduction of 42%, 95% CI 0.54–0.62 and OR increase of 68% [95% CI 1.56–1.81], respec­tively). Conclusion: A simple educational intervention likely contributed to sustained improvement in the appropriateness of PRBC transfusions.