Implementing a patient blood management programme in Brazil: challenges and implications for developing countries

Abstract

BackgroundPatient blood management (PBM) programmes have the intention of promoting the rational use of blood, relying on up‐to‐date medical‐scientific evidence in a multidisciplinary approach, where the patient is the main focus of transfusion decisions. These programmes not only increase patient safety levels, but they also have the potential of lowering hospital costs. The aim of this study was to describe the implementation of a PBM programme at a University hospital in Brazil.Study design and methodsThe discussions regarding this PBM project were initially undertaken among the managers of the hospital's Transfusion Unit. Audits of transfusion practices were carried out, and these indices were presented in meetings with the Transfusion Committee and with other important stakeholders, in order for this information to support the delineation of the programme's work fronts.ResultsThe project was promptly approved by the hospital's Board of Directors due to the relevance of the proposal, which required few financial resources as the project is mainly based on reorganization of workflows. The measures implemented included the following: didactic sessions aimed at the hospital staff, reformulation of the computerized system for the prescription of blood components, elaboration of a protocol for the use of antifibrinolytic drugs during the perioperative period and the institution of an outpatient clinic for evaluation of preoperative anaemia.ConclusionThe benefits and challenges of a PBM project in a country with limited resources are analysed, discussing specificities in the scope of Brazilian Transfusion Medicine in a pioneering way.