Transfusion Practice Research Articles

Opportunities to improve feedback to reduce blood component wastage: Results of a national scheme evaluation.

Blood components are costly and scarce. The Blood Stocks Management Scheme (BSMS) was established in the United Kingdom (UK) to support hospital transfusion services and national blood services through collection, analysis, and monthly feedback of data on blood component inventory and wastage management. There is a growing evidence base on how best to deliver feedback for quality improvement. We assessed the quality and utility of the monthly BSMS component reports. We assessed the content of BSMS reports issued in March 2023 against established criteria for effective feedback. Two researchers independently rated whether criteria spanning the five domains of goal setting, data collection, feedback content, feedback display and feedback delivery were fully, partially or not met. Disagreements were resolved through discussion. We conducted an online questionnaire survey of recipients of BSMS reports during March 2023 to assess their use of reports and seek suggestions for improvement. Five out of 20 criteria for effective feedback were fully met. Areas for improvement included placing more emphasis in the feedback on positive change, linking data and summary messages, and including specific suggestions for action. Respondents highlighted the value of benchmarked comparisons with other hospital transfusion services. There is scope for enhancing the effectiveness and utility of BSMS feedback reports and hence reducing wastage of blood components. This methodology for evaluation of feedback could be utilized to improve other areas of transfusion practice.

Attitude and practices of blood products transfusion in oncological surgeries: A comprehensive analysis

This study aimed to analyze the attitudes and practices of healthcare professionals regarding blood product transfusion in oncological surgeries, focusing on factors influencing decision-making and adherence to transfusion protocols.

Blood transfusion in the care of patients with visceral leishmaniasis: a review of practices in therapeutic efficacy studies.

Blood transfusion remains an important aspect of patient management in visceral leishmaniasis (VL). However, transfusion triggers considered are poorly understood. This review summarises the transfusion practices adopted in VL efficacy studies using the Infectious Diseases Data Observatory VL clinical trials library. Of the 160 studies (1980-2021) indexed in the IDDO VL library, description of blood transfusion was presented in 16 (10.0%) (n=3459 patients) studies. Transfusion was initiated solely based on haemoglobin (Hb) measurement in nine studies, combining Hb measurement with an additional condition (epistaxis/poor health/clinical instability) in three studies and the criteria was not mentioned in four studies. The Hb threshold range for triggering transfusion was 3-8 g/dL. The number of patients receiving transfusion was explicitly reported in 10 studies (2421 patients enrolled, 217 underwent transfusion). The median proportion of patients who received transfusion in a study was 8.0% (Interquartile range: 4.7% to 47.2%; range: 0-100%; n=10 studies). Of the 217 patients requiring transfusion, 58 occurred before VL treatment initiation, 46 during the treatment/follow-up phase and the time was not mentioned in 113. This review describes the variation in clinical practice and is an important initial step in policy/guideline development, where both the patient's Hb concentration and clinical status must be considered.

Unveiling transfusions: Analyzing blood product utilization patterns in a leading tertiary care center in Madhya Pradesh, India

Background: Blood transfusions play a pivotal role in medical care, saving millions of lives annually. The timely provision of safe blood is critical in various clinical scenarios, necessitating a careful balance between supply and demand. Despite advanced blood banking facilities globally, challenges persist in ensuring appropriate blood component utilization, prompting a need for clinical audits and optimization strategies. Aims and Objectives: This study aims to analyze the patterns of blood product utilization in a tertiary care hospital in Madhya Pradesh over 1 year, focusing on transfusion requests, cross-match-to-transfusion (C/T) ratios, transfusion indices (TIs), and indications for transfusions. Materials and Methods: A retrospective study was conducted at Shyam Shah Medical College from January 01, 2023, to December 31, 2023. Data from transfusion and cross-match requests in various departments were collected. C/T ratios, TI, and non-usage probability were computed to assess blood utilization efficiency. Results: Out of 16,682 cross-matched units, 71.93% were transfused. The overall C/T ratio was 1.39. The department of medicine demonstrated the most efficient blood usage with a C/T ratio of 1.16. Obstetrics and gynecology had the highest TI (1.06), while surgery had the lowest (0.71). Indications for transfusion included anemia (29.9%), pre-operative (17.2%), intraoperative (21.8%), and post-operative (31.1%). Conclusion: This study provides valuable insights into blood utilization patterns, offering a foundation for refining transfusion practices and enhancing the efficiency of blood management in the studied tertiary care hospital.

Use of educational manuals on blood components in hemotherapy and hematology services in Brazil: a scoping review

Hemotherapy has as its principle the rational use of blood, consisting of the appropriate use of blood components such as red blood cells, platelets, plasma and cryoprecipitate, obtained from the donation of whole blood. The use of educational manuals stands out as support in this process, which helps in the organization and safety of transfusion practice. The objective of the study was to map educational manuals on blood components in hemotherapy and hematology services in Brazil. This is a scoping review based on the recommendations of the Joanna Briggs Institute (JBI) and structured based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoing Reviews (PRISMA-ScR) checklist and was registered in the Open Science Framework, under DOI: 10.17605/OSF.IO/642JZ. The publications had a predominance of articles in Portuguese language 100%. There was a prevalence of studies with a descriptive approach 80%, action research 10% and randomized studies 10%, as well as publications carried out in Brazil 100%. The study showed us the importance of manuals and the difference caused by their use in terms of standardization in Brazilian health units.

Surgical patients' perception about risks related to blood transfusion: A cross-sectional survey.

To determine the perception of surgical patients at Aga Khan University Hospital (AKUH) about the risks related to blood transfusion. The ultimate aim was to influence patients' acceptability of blood transfusion by reducing their fears through effective counselling. AKUH has a hospital-based blood bank with more than 90% family replacement donation. Many patients perceive blood transfusion as a risky procedure. This survey will help healthcare practitioners in addressing patients' concerns more effectively while counselling them about blood transfusion. It was a cross-sectional survey of patients attending anaesthesia clinic at AKUH during the study period. It assessed patients' perception about adverse effects associated with blood transfusion. A total of 363 patients were included. Among the participants, 18% considered blood transfusion to be very often or always risky. Blood transfusion related infections were considered most frequently occurring adverse events. Female patients were more concerned about the risks (p = 0.046). Many patients consider blood transfusion as a high-risk procedure. Healthcare professionals need to understand patient's perceptions and conduct patient counselling accordingly. This will help physicians in addressing patient-specific concerns related to blood transfusion. Improved knowledge is hoped to translate into improvement in transfusion practices at the national level.

Are Healthcare Professionals Adequately Trained for Safe Blood Transfusions? Targeted Training to Bridge Knowledge Gaps.

Ensuring optimal blood transfusion practices relies on a robust expertise base that is indispensable across various professional fields. Recognizing this imperative, the current study aims to assess the knowledge levels of healthcare personnel and enhance transfusion quality through targeted continuing training initiatives. The preliminary survey was based on an anonymous questionnaire and we used correct response rate (CRR) as the main parameter evaluating the baseline level of knowledge. Then blood transfusion education sessions which focused on transfusion shortcomings were carried out. Finally, we assessed the impact of this training on the baseline education. From the total of 789 questionnaires distributed, we garnered 331 responses 23 from healthcare staff. The overall CRR for questions related to transfusion procedure knowledge was 33%. Notably, the per-transfusion step exhibited the highest control with CRR of 55% while noticeable gaps were observed in the pre-transfusion (CRR = 22%) and post-transfusion (CRR = 13%) phases. Profession wise variations in CRR were evident, with nurses recording the lowest percentage (CRR = 29%) compared to physicians (CRR = 39%) and technicians (CRR = 34%). Substantial differences were observed in the interpretation of Ultimate Control in the Patient's Bed (UCPB) among professions, especially affecting ABO identity, compatibility, and incompatibility cases. Following the blood transfusion training, attended by 105 participants, only 99 participants responded to the questionnaire post-training, expressing high satisfaction with the covered modules (80%). The knowledge enhancement encompassed all transfusion phases and the interpretation of clinical cases, notably ABO compatibility. Overall, there was a significant improvement in CRR from 33 to 53% (p < 0.001). This study demonstrates that the evaluation of knowledge should be carried out on a continuous manner in order to detect gaps in the professional sector and to ensure the effectiveness of training through well-targeted educational programs. The online version contains supplementary material available at 10.1007/s12288-024-01778-y.

Auditing plasma transfusion in intensive care: Use of decision time interval analysis.

To present a new method for displaying blood utilization data based on analysis of decision time intervals (DTIs). Retrospective study of patients treated in a medical intensive care unit (ICU), surgical ICU, or postcardiac surgery ICU at an academic hospital between January 2018 and June 2023. Each patient's episode of care was divided into a series of DTIs. Transfusions during each time interval were recorded. In total, 16,562 patients received 6980 units of plasma and 21,034 units of red blood cells during 111,557 time intervals of care. Patients had international normalized ratio (INR) values ranging from less than 1.0 to more than 4.0. Data on plasma transfusion at different INR values were displayed as the number of transfusion episodes, number of units given, or the proportion of DTIs with transfusion. Clinicians transfused plasma on 1.5% of occasions when the INR was 1.5 or less and on 2.2% of occasions when the INR was less than 2.0. Plasma was transfused without red blood cells in only 0.75% of DTIs. Transfusion practice was statistically different among the 3 ICUs. Compared with traditional methods of displaying the results of blood audits, DTI analysis displays information regarding the decision both to transfuse and to not transfuse. Utilization reviews that display data based on decision time analysis reveal clinical practice patterns very different from those suggested by traditional displays of plasma audit data.

Preoperative cross-matching in major elective surgical procedures in children: An audit of department’s transfusion practices

Abstract: AIMS: To determine the utilization of cross-matched packed red blood cell (PRBC) concentrate in children posted for major elective operative procedures. To evaluate the efficacy of a simple preoperative “screening criteria” for ordering preoperative cross-match. MATERIALS AND METHODS: Data were retrieved from online surgery scheduling system prospectively over a 4-month period (January–April 2022). The number of units cross-matched and those utilized were assessed. A screening criterion was devised in consultation with stakeholders for ordering blood. The utilization of PRBCs was reassessed after implementation of these criteria and reaudited (July–October 2022). A subset analysis of A1 (tunneled catheter placements) and A2 (core pediatric surgical procedures) groups was done to analyze blood utilization. RESULTS: Initial audit showed poor PRBC utilization with 46 units unused of the 54 cross-matched units, and most of these were from A1 group (3 of 29 units and 5 out of 25 units utilized in A1 and A2 groups, respectively). Reaudit after introducing cutoff criteria showed sharp decline (79.3%) in the number of cross-matched units and the number of units returned (84.6% decrease) in A1 group and the number of units returned unused dropped by 50% in the A2 group. There was visible reversal of indicators of utilization (cross-match to transfusion ratio dropped from 6.75 to 1.73 and TI increased from 0.163 to 0.613), indicating optimal utilization. CONCLUSION: This pilot audit clearly demonstrates the gap between requisition and utilization of cross-matched PRBCs. Formulating an effective screening criterion avoids unnecessary cross-matching and wastage of resources and maximizes utilization.

Improvement of Transfusion Practice in Cardiothoracic Surgery Through Implementing a Patient Blood Management Program.

In this study, we examined the impact of a patient blood management (PBM) program on red blood cell (RBC) transfusion practices in cardiothoracic surgery. The PBM program had 3 components: monitoring transfusions through an order communication system checklist, educating the medical team about PBM, and providing feedback to ordering physicians on the appropriateness of transfusion. The retrospective analysis examined changes in the hemoglobin levels triggering transfusion and the proportions of appropriate RBC transfusions before, during, and after PBM implementation. Further analysis was focused on patients undergoing cardiac surgery, with outcomes including 30-day mortality, durations of intensive care unit and hospital stays, and rates of pneumonia, sepsis, and wound complications. The study included 2,802 patients admitted for cardiothoracic surgery. After the implementation of PBM, a significant decrease was observed in the hemoglobin threshold for RBC transfusion. This threshold dropped from 8.7 g/dL before PBM to 8.3 g/dL during the PBM education phase and 8.0 g/dL during the PBM feedback period. Additionally, the proportion of appropriate RBC transfusions increased markedly, from 23.9% before PBM to 34.9% and 58.2% during the education and feedback phases, respectively. Among the 381 patients who underwent cardiac surgery, a significant reduction was noted in the length of hospitalization over time (p<0.001). However, other clinical outcomes displayed no significant differences. PBM implementation effectively reduced the hemoglobin threshold for RBC transfusion and increased the rate of appropriate transfusion in cardiothoracic surgery. Although transfusion practices improved, clinical outcomes were comparable to those observed before PBM implementation.

Trends in immunological markers of transfusion transmissible infections among blood donors in Mamfe District Hospital, Southwest Cameroon

BackgroundBlood transfusion is associated with exposure to blood Transfusion Transmissible Infection (TTIs). The threat posed by the blood-borne pathogens is disproportionately distributed in different healthcare facilities in Cameroon. Thus, there is a need for continuous surveillance of TTIs in the country. This study aimed to assess the screening procedure for blood transfusion and determine the trend in immunological markers of TTIs among blood donors at the Mamfe District Hospital.MethodsA prospective descriptive, cross-sectional and analytical study was conducted at Mamfe District Hospital from March to May 2022. A total of 165 blood donors were recruited by the consecutive sampling method. Donors were screened using both Rapid diagnostic tests,T. pallidum haemagglutination test and indirect enzyme-linked immunosorbent assay (ELISA) for the detection of TTIs. Data generated was entered into an Excel spreadsheet and analysed using the statistical software R, version 4.2.0. Statistical analysis included descriptive statistics of percentages, means ± standard deviation, and student t-test was used to compare both diagnostic techniques, and was considered significant when p < 0.05.ResultsA hundred and sixty-five donors were enrolled in the study with a male preponderance giving a male-female sex ratio of 22.5 and a mean age of 32.23 ± 8.60 years. The majority (75.2%) of the donors were of the O-positive blood type, repeat donors (69.1%) and were mainly family replacement and paid donors as against the voluntary blood donors (39.4% and 37.0% vs. 23.6% respectively). overall TTIs prevalence was 18.78% (31/165) (), with HBsAg being the most predominant marker at 12.12% (20/165) followed by Treponema pallidum, HCV and HIV antibodies at 4.85 (8/165), 1.21%(2/165), 0.60% (1/165) respectively. Except for the HBV, The prevalence of TTIs was higher when using a single RDT than the ELISA test, and the difference was significant (p < 0.05).ConclusionBloodborne pathogens remain a major menace to safe blood transfusion practice in Mamfe district hospital and their detection could be easily missed if the RDT method alone is used for donor screening. Therefore, the donor screening protocol in Mamfe District Hospital should systematically incorporate a confirmation diagnostic test such as ELISA.

Transfusion Practices in Severely Injured Patients at a Level 1 Trauma Center.

Acute trauma resuscitation is challenging and disorganized in low- and middle-income countries as there is lack of evidence-based transfusion practices with respect to ratio, volume, trigger, cutoff points for various triggers. This study aims to study the patterns of blood use in various mechanisms of injury, by interfacility transfer status and define triggers for transfusion of various blood components. Prospective observational study, emergency department of level 1 trauma center (August 2017-August 2018). Demographic, injury, clinical, laboratory, transfusion characteristics, and patient outcomes were collected from electronic hospital records and transfusion service records. We used multivariate logistic regression to identify triggers of transfusion of red blood cells, plasma, platelets (PLTs), cryoprecipitate, and mortality predictors. Among 986 severely injured patients 80% were males, 92% had blunt injuries and commonest trauma was Head. The median length of intensive care unit stay and hospital stay were more in a referred group. Patients brought to center directly received more massive transfusions (56, 13.05% vs. 48, 8.62%). Railway track injuries received the most total median packed red blood cells (PRBCs) units in both groups. The triggers for various blood product transfusions include: Hematocrit < 32.08 for PRBC, PT >16.9 s for plasma, PLT count <130 lakhs for platelets, MAP <89.7 mmHg and PT >18.2 s for cryoprecipitate. Railway track injuries with inferior extremity injuries required maximum transfusion requirements and were a trigger for PRBC, plasma, PLTs, and cryoprecipitate. Smartphone-based apps and transfusion prediction models can be framed based on the triggers and cut points.

Neonatal Blood Transfusion in Africa; Towards Optimizing Scarce Resource

Neonatal transfusion is a common practice in Africa, where many infants are born with low birth weight and require blood transfusions. The use of paediatric packs for neonatal blood transfusions has been recommended. However, the optimal use of these packs in Africa is not clearly understood by some healthcare practitioners. This review aims to provide insights into the optimal use of paediatric packs in neonatal transfusion in Africa.The World Health Organization (WHO) recommends restrictive transfusion practices for paediatric patients, including neonates, based on expert opinion. Transfusion triggers in neonates are controversial and mainly based on expert clinical opinion, although recent randomized controlled trials of ‘liberal’ versus ‘restrictive’ red cell transfusion policies in very low birth weight preterm babies are starting to influence clinical guidelines. Many neonatal red cell transfusions are given to replace losses from frequent blood sampling. This can be reduced by avoiding non-essential tests, using low-volume sample tubes, validated near patient testing, micro-techniques in the laboratory, and non-invasive monitoring where possible.The use of CMV-seronegative blood products for transfusion in low birth weight neonates is not deemed necessary. The primary rationale is that the risk of transfusion-transmitted infections should be reduced by stringent screening of donors, restrictive transfusion practice and certain interventions like irradiation of blood units before transfusion. A recent international survey of transfusion practices for extremely premature infants showed that factors considered “very important” regarding the need to administer blood transfusions included degree of oxygen requirement and need for respiratory support. Donor exposure can also be reduced by allocating single donor units, split into paedipacks, to babies predicted to need more than one transfusion episode within the expiry date of the donation. Implementing a program to improve compliance with neonatal intensive care unit transfusion guidelines was accompanied by a reduction in transfusion rate. The implementation of guidelines to improve compliance with neonatal intensive care unit transfusion guidelines can also reduce the transfusion rate.

SET domain containing 2 promotes megakaryocyte polyploidization and platelet generation through methylation of α-tubulin

BackgroundMegakaryocytes (MKs) are polyploid cells responsible for producing ∼1011 platelets daily in humans. Unraveling the mechanisms regulating megakaryopoiesis holds the promise for the production of clinical-grade platelets from stem cells, overcoming significant current limitations in platelet transfusion medicine. Previous work identified that loss of the epigenetic regulator SET domain containing 2 (SETD2) was associated with an increased platelet count in mice. However, the role of SETD2 in megakaryopoiesis remains unknown. ObjectivesHere, we examined how SETD2 regulated MK development and platelet production using complementary murine and human systems. MethodsWe manipulated the expression of SETD2 in multiple in vitro and ex vivo models to assess the ploidy of MKs and the function of platelets. ResultsThe genetic ablation of Setd2 increased the number of high-ploidy bone marrow MKs. Peripheral platelet counts in Setd2 knockout mice were significantly increased ∼2-fold, and platelets exhibited normal size, morphology, and function. By knocking down and overexpressing SETD2 in ex vivo human cell systems, we demonstrated that SETD2 negatively regulated MK polyploidization by controlling methylation of α-tubulin, microtubule polymerization, and MK nuclear division. Small-molecule inactivation of SETD2 significantly increased the production of high-ploidy MKs and platelets from human-induced pluripotent stem cells and cord blood CD34+ cells. ConclusionThese findings identify a previously unrecognized role for SETD2 in regulating megakaryopoiesis and highlight the potential of targeting SETD2 to increase platelet production from human cells for transfusion practices.

A novel measure to summarize blood transfusion practice during critical illness.

Large-scale observational studies have summarized transfusion practice using traditional measures of central tendency (e.g., the mean hemoglobin concentration at the time of transfusion). However, the mean hemoglobin concentration fails to identify specific hemoglobin concentration thresholds that drive practice. In the following brief report, we propose a novel measure of "practice discontinuity" that identifies specific practice-defining hemoglobin thresholds. We used the PINC AI Database (2016-2022) to identify adult patients admitted to an intensive care unit with at least one hemoglobin concentration measurement. For each day that hemoglobin was measured, we identified whether the patient received a red blood cell transfusion using hospital charge codes. We defined the "practice discontinuity" measure as the hemoglobin concentration at which there was the largest increase in transfusion use going from a higher to an incrementally lower hemoglobin concentration. We also calculated the mean and median pretransfusion hemoglobin concentrations. We identified 1,298,367 patients and 4,905,839 patient-days for inclusion. RBC transfusion occurred in a total of 530,654 (10.8%) patient-days. The overall pre-transfusion mean and median hemoglobin concentrations were 8.4 and 8.0 g/dL, respectively. The practice discontinuity measure identified 7.0 g/dL as the hemoglobin concentration at which transfusion use increased the most, from 46.6% of patient-days at a concentration of 7.0 g/dL to 74.8% of patient-days at a concentration of 6.9 g/dL. We propose that future studies of red blood cell transfusion practice consider inclusion of the practice discontinuity measure to more fully summarize clinical practice.

Nonclinical factors affecting intraoperative red blood cell transfusion: a systematic review.

There is significant variability in intraoperative red blood cell (RBC) transfusion practice. We aimed to use the theoretical domains framework (TDF) to categorize nonclinical and behavioural factors driving intraoperative RBC transfusion practice in a systematic review of the literature. We searched electronic databases from inception until August 2021 to identify studies evaluating nonclinical factors affecting intraoperative RBC transfusion. Using the Mixed Methods Appraisal Tool, we assessed the quality of included studies and identified relevant nonclinical factors, which were coded into TDF domains by two independent reviewers using NVivo (Lumivero, QSR International, Burlington, MA, USA). We identified common themes within domains and sorted domains based on the frequency of reported factors. Our systematic review identified 18 studies: nine retrospective cohort studies, six cross-sectional surveys, and three before-and-after studies. Factors related to the social influences, behavioural regulation, environmental context/resources, and beliefs about consequences domains of the TDF were the most reported factors. Key factors underlying the observed variability in transfusion practice included the social effects of peers, patients, and institutional culture on decision-making (social influences), and characteristics of the practice environment including case volume, geographic location, and case start time (environmental context/resources). Studies reported variable beliefs about the consequences of both intraoperative transfusion and anemia (beliefs about consequences). Provider- and institutional-level audits, educational sessions, and increased communication between surgeons/anesthesiologists were identified as strategies to optimize intraoperative transfusion decision-making (behavioural regulation). Our systematic review has synthesized the literature on nonclinical and behavioural factors impacting intraoperative transfusion decision-making, categorized using the TDF. These findings can inform evidence-based interventions to reduce intraoperative RBC transfusion variability. Open Science Framework ( https://osf.io/pm8zs/?view_only=166299ed28964804b9360c429b1218c1 ; first posted, 3 August 2022).

Transfusion Therapy in HIV: Risk Mitigation and Benefits for Improved Patient Outcomes

Transfusion therapy is a pivotal aspect of healthcare, especially for individuals living with Human Immunodeficiency Virus (HIV). This comprehensive review aims to dissect the intricate landscape of transfusion therapy in HIV patients, emphasizing the delicate balance between risks and benefits to achieve enhanced patient outcomes. With advancements in blood safety measures and antiretroviral therapy (ART), navigating the complexities of transfusion therapy in HIV management becomes paramount for healthcare professionals. The review consolidates current knowledge and emerging trends, encompassing challenges, benefits, risks, and strategies to optimize transfusion therapy for improved patient care. The paper delineates key areas, including blood safety measures such as nucleic acid testing (NAT) and pathogen reduction technologies, emphasizing their role in ensuring safer blood products for transfusion in HIV patients. Furthermore, it explores the impact of HIV on hematological disorders, delving into transfusion-transmitted infections and strategies to mitigate these risks. Additionally, it scrutinizes the therapeutic benefits of transfusion therapy in managing hematologic complications in HIV, while addressing potential risks, including immune reactions and adverse effects. Optimizing transfusion therapy in HIV necessitates personalized approaches, considering the individual patient's HIV status, comorbidities, and specific transfusion needs. The role of ART in reducing transfusion requirements and associated risks is highlighted, alongside emerging trends like novel therapies and alternative transfusion practices. Keywords: Transfusion therapy, HIV, blood safety, antiretroviral therapy, risks, benefits, patient outcomes, transfusion-transmitted infections, personalized treatment, hematology, blood products

Recent Trends and Practices in Blood Transfusion

Blood Transfusion is one of the most important, Potent and Critical therapeutic tools in the realm of Clinical Management of Patients. Modern Blood banking involves carefully coordinated sophisticated and integrated teamwork comprising of well experienced Technicians, Physicians along with the Donor/Patient support. It consists of latest Machinery and infrastructure to cater to the needs of patients, along with regular internal / external Audit, quality control and Calibration of Machines, which is vital to the efficient functioning of Blood Bank and delivery of smooth, accurate results. The aim of this study is to explore the various latest aspects of Blood Banking and reinforce the knowledge of Medical Community

Nurses Knowledge regarding Blood transfusion in Hayatabad Medical Complex, Peshawar

Background: Blood transfusion is a critical and life-saving procedure in medical practice, necessitating high levels of knowledge and competency among healthcare providers, particularly nurses, to ensure patient safety and minimize risks associated with transfusion. Despite its importance, gaps in knowledge and training among nursing professionals can significantly impact the quality of care and patient outcomes. Objective: This study aimed to assess the knowledge of nurses regarding blood transfusion practices at a tertiary care hospital in Peshawar and to identify educational gaps that could be addressed to improve the safety and efficacy of transfusion services. Methods: A cross-sectional descriptive study was conducted among Registered Nurses working at Hayatabad Medical Complex, Peshawar. A total of 206 nurses were recruited using convenience sampling. The blood transfusion knowledge questionnaire, adapted from previous studies with modifications to include demographic questions and specific queries related to blood transfusion, was used for data collection. Statistical analysis was performed using SPSS version 25, focusing on calculating means, standard deviations, frequencies, and percentages. Results: The study found that 63.60% of the participants were female, and the majority (52.4%) were aged between 31 to 40 years. Regarding blood transfusion practices, 89.3% correctly identified the use of a blood transport box for transporting blood from the blood bank to the ward. Furthermore, 90.77% acknowledged checking the details on the bag label and blood request form as the first step in collecting a blood bag. However, the study highlighted a moderate level of overall knowledge about blood transfusion among nurses, with significant gaps in training and education noted. Conclusion: The findings suggest that while nurses at the tertiary care hospital in Peshawar have a reasonable understanding of some aspects of blood transfusion practices, there is a clear need for enhanced training programs and the inclusion of comprehensive transfusion medicine education in nursing curricula. Addressing these gaps is essential for improving patient safety and the overall quality of care in transfusion services.

Intraoperative and immediate postoperative transfusion: Clinical-hematological profile of transfunded patients in a university hospital

IntroductionThe transfusion practice by surgery blood reserve, varied among services, must be performed through the rational and restrictive use of blood components because it is a scarce and expensive resource for health care services. ObjectiveAnalyze the use of blood products for surgery blood reserve by means of the study of the clinical-hematological profile of patients submitted to intraoperative and immediate postoperative transfusions. MethodsThis was an observational, cross-sectional, and retrospective study, conducted by collecting biological, operational, and laboratory variables, involving 680 patients at a university hospital who had elective surgery with surgery blood reserve request sent during the period from October 2021 to October 2022. ResultsThe overall transfusion rate was 25.44%, and the mean preoperative hemoglobin level of transfused patients was 9.74 ± 2.50 g/dL, with the mean number of transfusions packed red blood cell units was 1.58 ± 0.77. Patients with higher preoperative hemoglobin levels were less likely to have transfusion (p < 0.001) and patients who had surgical oncologic were more likely to require transfusion (p = 0.048). The transfusion rate of packed red blood cells and platelets concentrates, compared to what was requested, was 15.86% and 5.82%. ConclusionThere is a tendency of transfusions to follow restrictive models, with higher transfusion probability in surgical oncologic. Furthermore, there should be more a conscise use of the surgery blood reserves request.