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南非布隆方丹大学学术医院血小板输注使用情况审计。

An audit of the use of platelet transfusions at Universitas Academic Hospital, Bloemfontein, South Africa.

作者信息

Sonnekus P H, Louw V J, Ackermann A M, Barrett C L, Joubert G, Webb M J

机构信息

Department of Internal Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.

Division of Clinical Haematology, Department of Internal Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.

出版信息

Transfus Apher Sci. 2014 Dec;51(3):44-52. doi: 10.1016/j.transci.2014.10.011. Epub 2014 Oct 16.

Abstract

An audit was performed at a tertiary hospital in Bloemfontein, South Africa, to establish whether clinicians adhered to local platelet transfusion guidelines. The audit showed poor compliance with local guidelines, with 34% of platelet transfusions not aligned with guidelines and 29.9% of transfusions administered to patients with platelet counts of ≥ 150 × 10(9)/L. When compared to medical disciplines, surgical disciplines tended significantly more to transfuse platelets inappropriately (17.1% and 53.7%, respectively; p < 0.0001). Documentation was poor and in 48.4% of orders for platelets, the indication for the platelet transfusion was not clearly stated. Considerable cost could be avoided with improved adherence to guidelines. This study emphasises the need for improving education in transfusion medicine amongst medical doctors. It is hoped that the information gleaned from this study would assist in the design of educational programmes in transfusion medicine as we attempt to close the existing gaps in knowledge and skills in the field, while ensuring that blood is transfused in a cost-effective and appropriate manner.

摘要

在南非布隆方丹的一家三级医院进行了一项审计,以确定临床医生是否遵守当地的血小板输血指南。审计结果显示,对当地指南的依从性较差,34%的血小板输血不符合指南,29.9%的输血是给血小板计数≥150×10⁹/L的患者。与医学学科相比,外科学科更倾向于不恰当地输注血小板(分别为17.1%和53.7%;p<0.0001)。记录情况不佳,在48.4%的血小板医嘱中,血小板输血的指征未明确说明。通过更好地遵守指南,可以避免相当大的成本。本研究强调了改善医生输血医学教育的必要性。希望从本研究中收集到的信息将有助于设计输血医学教育项目,因为我们试图弥合该领域现有知识和技能的差距,同时确保以具有成本效益和适当的方式进行输血。

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