Tordon Bryan, Meirovich Harley, Malkin Amie, Pavenski Katerina, Moorehead Amy, Ginsborg Lette, Saeed Samia, Shehata Nadine, Callum Jeannie, Cserti-Gazdewich Christine, Lieberman Lani, Pendergrast Jacob, Lin Yulia
Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Alberta Precision Laboratories (Formerly Calgary Laboratory Services), Calgary, Alberta, Canada.
Transfusion. 2024 Dec;64(12):2371-2379. doi: 10.1111/trf.18035. Epub 2024 Oct 1.
It is uncertain how transfusion knowledge translates to practice. The purpose of the study was to determine if higher scores on a validated Transfusion Camp knowledge assessment test were associated with transfusion order appropriateness.
Eligible participants included postgraduate trainees and faculty physicians who had prescribed at least four transfusion orders in the preceding 6 months at two hospitals. Participant data and knowledge were collected using a web-based questionnaire with a validated Transfusion Camp knowledge assessment tool. The most recent 4-10 consecutive transfusion orders per prescriber were independently dually adjudicated for appropriateness based on published criteria. The primary outcome was the correlation between the score on six questions on red blood cells (RBCs), platelets (PLTs), and plasma from the validated test and the percentage order appropriateness. Generalized linear regression was conducted to determine if factors (sex, specialty, participation in Transfusion Camp, previous transfusion education, self-rated knowledge) were associated with appropriate orders.
Seventy-four participants (45 trainees, 29 faculty; 31 females, 43 males) completed the test. Median score was 66.7% (interquartile range [IQR]: 50.0, 83.3) for six questions on RBCs, PLTs, and plasma transfusions. Of 546 transfusion orders adjudicated, appropriateness was 90.7% (95% confidence interval [CI]: 87.9%-93.0%). The correlation between prescriber test scores and order appropriateness was very weak (r = -.08). In multivariable analysis, female prescribers (p = .02) and beginner (vs. intermediate) self-rated knowledge (p = .01) were associated with higher transfusion appropriateness.
Transfusion knowledge test scores did not correlate with order appropriateness. Factors other than knowledge are key to understanding how to improve appropriate blood use.
输血知识如何转化为实践尚不确定。本研究的目的是确定在经过验证的输血训练营知识评估测试中得分较高是否与输血医嘱的合理性相关。
符合条件的参与者包括在两家医院前6个月内开具至少4份输血医嘱的研究生学员和教员医生。使用基于网络的问卷和经过验证的输血训练营知识评估工具收集参与者的数据和知识。根据已发表的标准，对每位开方者最近连续4 - 10份输血医嘱进行独立双盲判定其合理性。主要结果是经过验证的测试中关于红细胞（RBC）、血小板（PLT）和血浆的六个问题的得分与医嘱合理性百分比之间的相关性。进行广义线性回归以确定因素（性别、专业、参加输血训练营、以前的输血教育、自我评估的知识）是否与合理医嘱相关。
74名参与者（45名学员，29名教员；31名女性，43名男性）完成了测试。关于RBC、PLT和血浆输血的六个问题的中位数得分是66.7%（四分位间距[IQR]：50.0，83.3）。在判定的546份输血医嘱中，合理性为90.7%（95%置信区间[CI]：87.9% - 93.0%）。开方者测试得分与医嘱合理性之间的相关性非常弱（r = -0.08）。在多变量分析中，女性开方者（p = 0.02）和自我评估知识为初学者（相对于中级）（p = 0.01）与更高的输血合理性相关。
输血知识测试得分与医嘱合理性不相关。知识以外的因素是理解如何改善合理用血的关键。
