From the NHS Blood & Transplant, 75 Cranmer Terrace, Tooting, London SW17 0RB, UK.
Kings College Hospital NHS Trust, Denmark Hill, London SE5 9RS, UK.
QJM. 2017 Nov 1;110(11):735-739. doi: 10.1093/qjmed/hcx150.
The NICE guidelines for blood transfusion and the patient blood management recommendations state that a single unit of red cells should be the standard dose for patients with stable anaemia who are not bleeding. Studies have shown that changing clinical transfusion practice can be difficult and that many clinicians' order two units of blood as standard for patients needing a transfusion.
A collaborative project between NHS Blood and Transplant and Kings College Hospital started in September 2014 to evaluate the impact of a single unit policy on blood usage.
Training and education was undertaken for clinical staff on eight general medical wards and all staff working in the blood transfusion laboratory. We collected transfusion data for 12 months, (6 months before and after implementation).
There was a decrease of 50% red cell unit usage between the two periods, equating to a unit cost saving of £28 670. The number of single unit transfusions, increased from 30 to 53% whilst the number of two units decreased from 65 to 43% (P < 0.001).
DISCUSSION/CONCLUSION: This project has shown that transfusion practice can be changed and savings in blood usage can be achieved through the successful implementation of the single unit transfusions policy. Key to the implementation was engagement from key medical staff within the medical department in which the policy was implemented and support from the hospital transfusion team. Continued attention and training shall be needed to support these, and implement other, patient blood management recommendations.
NICE 输血指南和患者血液管理建议指出，对于稳定贫血且无出血的患者，应将单个单位的红细胞作为标准剂量。研究表明，改变临床输血实践可能很困难，许多临床医生会将两个单位的血液作为标准为需要输血的患者开具。
NHS 血液与移植中心和国王学院医院于 2014 年 9 月开始合作开展了一个项目，以评估单一单位政策对血液使用的影响。
对 8 个普通内科病房和输血实验室的所有工作人员进行了临床工作人员的培训和教育。我们收集了 12 个月的输血数据（实施前后各 6 个月）。
两个时期之间的红细胞单位使用量减少了 50%，相当于节省了 28670 英镑的单位成本。单一单位输血的数量从 30%增加到 53%，而两个单位输血的数量从 65%减少到 43%（P < 0.001）。
讨论/结论：该项目表明，通过成功实施单一单位输血政策，可以改变输血实践并节省血液使用量。该政策实施的关键是得到实施部门内的关键医务人员的参与，并得到医院输血团队的支持。需要继续关注和培训，以支持这些措施，并实施其他患者血液管理建议。
