Khetan Dheeraj, Katharia Rahul, Pandey Hem Chandra, Chaudhary Rajendra, Harsvardhan Rajesh, Pandey Hemchandra, Sonkar Atul
Department of Transfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Department of Hospital Administration, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Asian J Transfus Sci. 2018 Jan-Jun;12(1):27-33. doi: 10.4103/ajts.AJTS_29_17.
Blood transfusion chain can be divided into three phases: preanalytical (patient bedside), analytical (steps done at transfusion services), and postanalytical (bedside). Majority (~70%) of events due to blood transfusion have been attributed to errors in bedside blood administration practices. Survey of bedside transfusion practices (pre-analytical and post analytical phase) was done to assess awareness and compliance to guidelines regarding requisition and administration of blood components.
Interview-based questionnaire of ward staff and observational survey of actual transfusion of blood components in total 26 wards of the institute was carried out during November-December 2013. All the collected data were coded (to maintain confidentiality) and analyzed using SPSS (v 20). For analysis, wards were divided into three categories: medical, surgical, and others (including all intensive care units).
A total of 104 (33 resident doctors and 71 nursing) staff members were interviewed and observational survey could be conducted in 25 wards during the study period. In the preanalytical phase, major issues were as follows: lack of awareness for institute guidelines (80.6% not aware), improper sampling practices (67.3%), and prescription related (56.7%). In the postanalytical phase, major issues were found to be lack of consent for blood transfusion (72%), improper warming of blood component (~80%), and problems in storage and discarding of blood units.
There is need to create awareness about policies and guidelines of bed side transfusion among the ward staff. Regular audits are necessary for compliance to guidelines among clinical staff.
输血链可分为三个阶段：分析前（患者床边）、分析（输血服务部门进行的步骤）和分析后（床边）。大多数（约70%）输血相关事件归因于床边输血操作错误。开展了床边输血操作（分析前和分析后阶段）调查，以评估对血液成分申请和输注指南的知晓情况及遵循程度。
2013年11月至12月期间，对该机构26个病房的病房工作人员进行了基于访谈的问卷调查，并对实际输血情况进行了观察性调查。所有收集的数据均进行编码（以保密），并使用SPSS（v20）进行分析。为进行分析，病房分为三类：内科、外科和其他（包括所有重症监护病房）。
在研究期间，共访谈了104名工作人员（33名住院医生和71名护士），并在25个病房进行了观察性调查。在分析前阶段，主要问题如下：对机构指南缺乏知晓（80.6%不知道）、采样操作不当（67.3%）以及与处方相关的问题（56.7%）。在分析后阶段，主要问题包括输血缺乏同意（72%）、血液成分加温不当（约80%）以及血液单位储存和丢弃方面的问题。
需要提高病房工作人员对床边输血政策和指南的认识。对临床工作人员遵循指南情况进行定期审核很有必要。
