Department of Pathology, HATS Division, Johns Hopkins Medical Institutions, Baltimore, Maryland 21205, USA.
Transfusion. 2011 Jul;51(7):1469-76. doi: 10.1111/j.1537-2995.2010.03039.x. Epub 2011 Feb 8.
Platelet (PLT) transfusions are essential for patients who are bleeding or have an increased risk of bleeding due to a decreased number or abnormal function of circulating PLTs. A shelf life of 5 days for PLT products presents an inventory management challenge. In 2006, greater than 10% of apheresis PLTs made in the United States outdated. It is imperative to have a sufficient number of products for patients requiring transfusion, but outdating PLTs is a financial burden and a waste of a resource.
We present the approach used in our institution to anticipate inventory needs based on current patient census and usage. Strategies to predict usage and to identify changes in anticipated usage are examined. Annual outdating is reviewed for a 10-year period from 2000 through 2009.
From January 1, 2000, through December 2009, there were 128,207 PLT transfusions given to 15,265 patients. The methods used to anticipate usage and adjust inventory resulted in an annual outdate rate of approximately 1% for the 10-year period reviewed. In addition we have not faced situations where inventory was inadequate to meet the needs of the patients requiring transfusions.
We have identified three elements of our transfusion service that can minimize outdate: a knowledgeable proactive staff dedicated to PLT management, a comprehensive computer-based transfusion history for each patient, and a strong two-way relationship with the primary product supplier. Through our comprehensive program, based on the principles of providing optimal patient care, we have minimized PLT outdating for more than 10 years.
血小板(PLT)输注对于因循环 PLT 数量减少或功能异常而出血或有出血风险增加的患者至关重要。PLT 产品的保质期为 5 天,这给库存管理带来了挑战。2006 年,美国生产的超过 10%的单采 PLT 过期。为需要输血的患者提供足够数量的产品是当务之急,但 PLT 过期是一种经济负担,也是资源浪费。
我们介绍了我们机构在根据当前患者人数和使用情况预测库存需求方面所采用的方法。检查了预测使用情况和识别预期使用变化的策略。回顾了 2000 年至 2009 年的 10 年期间的年度过期情况。
从 2000 年 1 月 1 日至 2009 年 12 月,有 15265 名患者接受了 128207 次 PLT 输血。用于预测使用情况和调整库存的方法导致在审查的 10 年期间,每年的过期率约为 1%。此外,我们还没有遇到过库存不足以满足需要输血的患者需求的情况。
我们已经确定了我们的输血服务的三个要素,可以最大限度地减少过期:一支知识渊博、积极主动、专注于 PLT 管理的员工队伍,为每位患者提供全面的基于计算机的输血史,以及与主要产品供应商建立强大的双向关系。通过我们基于为患者提供最佳护理原则的综合计划,我们已经将 PLT 过期时间减少了 10 多年。