Improved Safety and Efficacy with Standardised Plasmapheresis Protocol

Abstract

Background/Problem: Plasmapheresis is a procedure that involves extracorporeal separation of blood products resulting in filtered plasma, which has therapeutic application in various diseases including TTP. The plasmapheresis ordering with the labs involved can be tedious, time consuming and is prone to errors. With electronic medical records, we have the opportunity to have order sets for most complex orders. We developed plasmapheresis order set for our VA and prospectively assessed the impact of utility of using the plasmapheresis order set.Methods:We created a mock patient clinical scenario in which 5 Hematology oncology fellows were required to place plasmapheresis orders for a case of TTP using CPRS at the VA. Collected data included the time required to place the orders and the completed orders list. The complete orders list was further analyzed to detect errors. Errors were defined as either omitted orders or orders, which needed to be changed. We created a plasmapheresis order set in CPRS. After education on using the plasmapheresis order set, we repeated the mock patient clinical scenario with the same 5 hematology oncology fellows. The time required to place the orders and the errors were calculated. The difference in the error rate and the total time before and after the use of order set was analyzed.Results:The average time to place the orders pre-order set is 18 minutes and error rate is 15.4 per fellow and with the order set the total time was reduced to 5 minutes and the error rate is 0.4 per fellow. There was a 72% reduction in the total time and 97% reduction in the error rate.Conclusions:Standardized plasmapheresis protocol tremendously reduces the time taken to place the orders along with significant reduction in the error rate. This project demonstrates the application of clinical informatics better patient care. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.