How to reduce rapidly destruction of labile blood components at the health facilities level? The experience of Centre Hospitalier de la Côte Basque

Abstract

The destruction of labile blood components (LBC) is of major concern. The objective was to carry out actions aiming to rapidly reduce this rate and to evaluate results in a single institution. From 2017 we developed in the Centre Hospitalier de la Côte Basque a strategy in order to struggle against this problem including: 1/general information of prescriptors for reducing LBC waste, 2/fractioned delivery of RBC unit per unit, 3/recommendations to nurses, 4/information on platelets reserve, 5/new policy for ambulances and emergency unit: transfusion emergency package conditioned in single RBC units including a temperature recorder. Following the implementation of these measures, we analyzed the evolution of waste regarding number and distribution of causes. In contrast to stability of LBC destructions during these recent years between 0.84 and 0.97% we observed a marked decrease in 2017 (0.56%) and the first six months of 2018 (0.28%). Considering the evolution of causes between 2016 and 2017 we noticed for instance a disappearance of destructions due to patient' refusal and out of time of expiry or at level of the mobile emergency unit. Of note reduction of destruction is marked in the three categories of LBC. However, there still remains a large room for improvement regarding avoidable causes of destruction. It is possible to reduce very rapidly and significantly the fraction of LBC destruction in a health facility thanks to measures including information, teaching, organization and material conducted both in the blood bank and in clinical departments.