Patidar Gopal Kumar, Kaur Daljit
Department of Transfusion Medicine, Adlakha Medical Center, Amritsar, Punjab, India.
Department of Transfusion Medicine, Max Super-speciality Hospital, Shalimar Bagh, New Delhi, India.
Asian J Transfus Sci. 2018 Jul-Dec;12(2):141-145. doi: 10.4103/ajts.AJTS_135_17.
Auditing and education are the tools for improvement in the transfusion practices. Clinicians are not providing patient's demographic data and medical history to the blood bank that required transfusion. This missing information in blood request forms can lead to transfusion reactions to the patient. So we planned to analyse the blood request forms received at our blood bank and the impact of educational program for the clinicians.
A total of 6894 blood request forms were received from the month of July 2014 to December 2014 at a blood bank in Amritsar, India. We evaluated for completeness of the blood request form in parameter columns like second identification (CR No. or Father/Husband Name), diagnosis, pre transfusion hematological parameters, quality and quantity of blood component required, history of previous transfusion and adverse transfusion reaction, urgency of transfusion, medical officer name and signature, phlebotomist name and signature etc. A series of CMEs on "Safe Transfusion Practices" were organized for clinicians and hospital staff from 1st August 2014 and improvement in clinicians' behavior was analysed.
A total of 60.83% requests were not filled completely during the study period. Of these 91.42% were in the month of July, which decreased to 48.76% in the month of December 2014 with a total improvement of 42.66%. Incomplete second identification (91.03%) and history of previous transfusion and adverse transfusion reactions (80.21%) were the commonest incomplete fields in the month of July 2014. In the month of December 2014, an improvement in incomplete second identification was observed (12.8%) however phlebotomist signature was still a major incomplete field (45.19%). A statistically significant (p value = 0.004, paired 't' test) improvement in completeness of forms was observed.
Results of medical audit and using those as a basis for developing a highly targeted educational program, can improve the clinicians' approch towards transfusion practices.
审核与教育是改善输血实践的工具。临床医生未向需要输血的血库提供患者的人口统计学数据和病史。血库申请表中这些缺失的信息可能会导致患者发生输血反应。因此，我们计划分析我们血库收到的血库申请表以及针对临床医生的教育计划的影响。
2014年7月至12月，印度阿姆利则的一家血库共收到6894份血库申请表。我们评估了血库申请表在参数栏中的完整性，如二次识别（病历号或父亲/丈夫姓名）、诊断、输血前血液学参数、所需血液成分的质量和数量、既往输血史和输血不良反应、输血紧迫性、医务人员姓名和签名、采血员姓名和签名等。2014年8月1日起为临床医生和医院工作人员组织了一系列关于“安全输血实践”的继续医学教育，并分析了临床医生行为的改善情况。
在研究期间，共有60.83%的申请表填写不完整。其中，91.42%发生在7月，到2014年12月降至48.76%，总体改善率为42.66%。2014年7月，最常见的不完整项目是二次识别不完整（91.03%）和既往输血史及输血不良反应（80.21%）。2014年12月，二次识别不完整情况有所改善（12.8%），但采血员签名仍是主要的不完整项目（45.19%）。观察到申请表完整性有统计学意义的改善（p值=0.004，配对t检验）。
医学审核结果并将其作为制定高度针对性教育计划的基础，可以改善临床医生在输血实践中的做法。
