Williams R L, McLellan D, Lees S, Dunlop D
Department of Orthopaedics, Cardiff Royal Infirmary, Wales, UK.
J R Coll Surg Edinb. 1997 Oct;42(5):314-6.
A retrospective audit of blood transfusions was carried out in Cardiff Royal Infirmary (CRI) to investigate how efficiently blood was requested and used by the various clinical directorates. Excessive crossmatch/transfusion (C/T) ratios were found for a number of operations. In an attempt to improve practices, a pilot study was carried out between the Department of Haematology and the largest single requesting group, the Orthopaedic Directorate. As a result of a preliminary retrospective audit, crossmatch guidelines were revised, with more reliance on the group and antibody screen (G & S) for low-risk operations. A subsequent prospective audit showed major reductions in crossmatch requests and a general decrease in C/T ratios to very efficient levels without any patient morbidity. Blood was freed for urgent use elsewhere, and significant cost improvements resulted. This study, using the orthopaedic surgery department as a model, shows the value of inter-departmental audit and supports the experience of other centres using similar methods to make considerable savings in the amount of blood crossmatched unnecessarily.
在加的夫皇家医院（CRI）对输血情况进行了一项回顾性审计，以调查各个临床科室对血液的申请和使用效率如何。发现许多手术的交叉配血/输血（C/T）比例过高。为了改进做法，血液学系与最大的单一申请组——骨科开展了一项试点研究。经过初步回顾性审计，修订了交叉配血指南，对于低风险手术更多地依赖血型鉴定和抗体筛查（G&S）。随后的前瞻性审计显示，交叉配血申请大幅减少，C/T比例总体下降到非常高效的水平，且没有任何患者出现并发症。血液得以腾出来供其他地方紧急使用，成本也显著降低。本研究以骨外科为模型，展示了部门间审计的价值，并支持其他中心采用类似方法在不必要的交叉配血数量上实现大幅节省的经验。
