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一家三级教学医院新鲜冰冻血浆和血小板使用情况的临床审计以及一份新输血申请表的影响

Clinical audit of the use of fresh-frozen plasma and platelets in a tertiary teaching hospital and the impact of a new transfusion request form.

作者信息

Hui C-H, Williams I, Davis K

机构信息

Transfusion Medicine Unit, Royal Adelaide Hospital Campus, Institute of Medical and Veterinary Science, Adelaide, South Australia, Australia.

出版信息

Intern Med J. 2005 May;35(5):283-8. doi: 10.1111/j.1445-5994.2005.00803.x.

Abstract

AIM

To carry out an audit of the appropriateness of fresh-frozen plasma (FFP) and platelets (Plt) transfusion with reference to the Australian National Health and Medical Research Council/Australian Society of Blood Transfusion Clinical Practice Guidelines, and to assess the impact of a self-educating transfusion request form.

METHODS

A prospective review of the clinical indications and laboratory data in all transfusion episodes of FFP and Plt occurring in a tertiary teaching hospital in South Australia in two 2-month periods of the years 2002 and 2003.

RESULTS

Reversal of warfarin has emerged as the major indication to transfuse FFP (34%). More than 72% FFP and 88% Plt were prescribed in an appropriate manner, and the majority were monitored adequately. The transfusion request form further improved the appropriate uses and was met with a satisfactory compliance. Further grounds for improvement are in FFP usage by the haematology unit and in cardiac bypass surgery, and Plt by surgical units.

CONCLUSION

Clinical transfusion audit helps to identify current pattern of usage and areas of improvement. A self-educating transfusion specific request form is also beneficial.

摘要

目的

参照澳大利亚国家卫生与医学研究委员会/澳大利亚输血协会临床实践指南,对新鲜冰冻血浆(FFP)和血小板(Plt)输注的适宜性进行审核,并评估自我教育输血申请表的影响。

方法

对2002年和2003年南澳大利亚一家三级教学医院两个为期2个月时间段内所有FFP和Plt输血事件的临床指征和实验室数据进行前瞻性回顾。

结果

华法林逆转已成为输注FFP的主要指征(34%)。超过72%的FFP和88%的Plt处方合理,且大多数得到了充分监测。输血申请表进一步改善了合理使用情况,并获得了令人满意的依从性。血液科和心脏搭桥手术中FFP的使用以及外科手术中Plt的使用仍有进一步改进的空间。

结论

临床输血审核有助于确定当前的使用模式和改进领域。自我教育输血专用申请表也有益处。

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