Practices for rational use of blood components in a universitary hospital

to produce improvements in transfusion practices through the implementation of an educational program for health professionals in a university hospital.

Methods:

this is an interventional and prospective study, with pre- and postanalysis of an educational intervention. The research was developed at the University Hospital of the Universidade Federal de Sergipe, involving participation of health professionals in the stage of training, during the month of February 2011, in addition to the monitoring of blood transfusions performed in the preand post-intervention periods. Transfusion practices were investigated upon request for transfusion or devolution of unused blood components. Knowledge of health professionals was assessed based on the responses to a questionnaire about transfusion practices.

Results:

during the educative campaign, 63 professionals were trained, including 33 nurses or nursing technicians and 30 physicians. Among the doctors, there was a statistically significant gain of 20.1% in theoretical knowledge (p=0.037). Gain in the nursing group was even higher: 30.4% (p=0.016). The comparative analysis of transfusion request forms showed a non-significant decrease from 26.7 to 19.5% (p=0.31) in all forms with incomplete information. We also observed a statistically significant improvement in relation to the filling of four items of transfusion request.

Conclusion:

there was a significant improvement of the entire process related to blood transfusions after interventional project conducted in February 2011.

Keywords:
erythrocyte transfusion; scientific exhibitions; platelet transfusion; comparative study

Hospital sectors	Doctors (n=30) % of improvement (p)	Nurses (n=33) % of improvement (p)
ICU (n=13)	21.2 (p=0.001)	13.6 (p=0.04)
Pediatrics (n=16)	13.92 (p=0.02)	26.4 (p<0.0001)
Medical clinics (n= 18)	7.81 (p=0.25)	24 (p=0.001)
Surgical clinics (n= 15)	10.06 (p=0.14)	5 (p=0.77)
Lab (n=1)	-	5 (p=0.56)

	Pre-intervention (n=247)	Post-intervention (n=565)	p-value
Sex
Female	77 (58.8%)	133 (48.9%)	0.06
Sector
Medical clinic	25 (19.1%)	63 (23.2%)	<0.05
Surgical clinic	64 (48.9%)	144 (52.9%)	<0.05
Pediatrics	32 (24.4%)	37(13.6%)	<0.05
Type of blood component
Packed red cells	212 (85.8%)	437 (77.3%)	0.06
Fresh frozen plasma	28 (11.3%)	107 (18.9%)	0.06
Platelets concentrated	7 (2.9%)	15 (2.7%)	0.06
Diagnosis
Neoplasia	28 (21.4%)	71 (26.2%)	0.01
Visceral leishmaniasis	18 (13.7%)	16 (5.8%)	0.01
Sickle cell anemia	15 (11.5%)	16 (5.9%)	0.01
Indications
Surgical reservation	57 (43.5%)	119 (43.8%)
Conformity	33 (25.2%)	91 (33.5%)	0.21
Nonconformity	6 (4.6%)	9 (3.3%)	0.36
Incomplete filling	35 (26.7%)	53 (19.5%)	0.17

Request item	Pre	Post	Improvement	p-value
Registration	62.6%	77.8%	15.20%	0.02
Sector	79.4%	89.8%	10.40%	0.03
Hemoglobin	35.1%	59.2%	24.10%	0.04
History of transfusion reaction	34.4%	59.2%	24.80%	0.02
Time of request	75.6%	55.3%	-20.30%	0.002
Day of request	96.2%	98.5%	2.30%
Date of birth	92.4%	95.6%	3.20%
Diagnosis	87.8%	93.8%	6%
Bed	64.1%	67.3%	3.20%
Weight	43.5%	60%	16.50%
Age	90.1%	96.4%	6.30%
Type of request	72.5%	78.9%	6.40%
Legibility of handwriting	93.9%	96.4%	2.50%
Sex	95.4%	92%	-3.40%
Platelets	8.4%	8%	-0.40%
Legibility of carbon copy	52.7%	32%	-20.70%

Associação Médica Brasileira R. São Carlos do Pinhal, 324, 01333-903 São Paulo SP - Brazil, Tel: +55 11 3178-6800, Fax: +55 11 3178-6816 - São Paulo - SP - Brazil
E-mail: ramb@amb.org.br

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