Yeh C-J, Wu C-F, Hsu W-T, Hsieh L-L, Lin S-F, Liu T-C
Blood Bank, Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Vox Sang. 2006 Oct;91(3):270-4. doi: 10.1111/j.1423-0410.2006.00819.x.
The demand for transfusions has increased rapidly in southern Taiwan. Between 1993 and 2003, requests for fresh-frozen plasma (FFP) in particular rose dramatically at Kaohsiung Medical University Hospital (KMUH). Transfusion orders were not tightly regulated, and inappropriate use of blood products was common.
We carried out a prospective analysis of transfusion requests from October 2003 to January 2004 at KMUH, and then repeated the audit for another 3-month period after the clinical faculty had undergone five sessions of education on transfusion guidelines. Later, our consultant haematologist applied computerized guidelines to periodic audits.
A 5.2% decrease in inappropriate FFP usage followed the educational programme and a further 30% reduction took place after the application of computerized transfusion guidelines. With the guidelines and periodic audits, FFP transfusions decreased by 74.6% and inappropriate requests from 65.2% to 30%.
Hospital policy, computerized transfusion guidelines and periodic audits greatly reduced inappropriate FFP transfusions. An educational campaign had a more limited effect.
台湾南部对输血的需求迅速增长。1993年至2003年间，高雄医学大学医院（KMUH）对新鲜冰冻血浆（FFP）的需求尤其急剧上升。输血医嘱未得到严格规范，血液制品的不当使用很常见。
我们对高雄医学大学医院2003年10月至2004年1月的输血申请进行了前瞻性分析，然后在临床教师接受了五期输血指南教育后，又进行了为期3个月的重复审核。后来，我们的血液学顾问应用计算机化指南进行定期审核。
教育项目实施后，FFP不当使用减少了5.2%，应用计算机化输血指南后又进一步减少了30%。通过指南和定期审核，FFP输血减少了74.6%，不当申请从65.2%降至30%。
医院政策、计算机化输血指南和定期审核大大减少了FFP的不当输血。教育活动的效果较为有限。
