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Pediatric patients who undergo spinal corrective surgery often require multiple blood product transfusions. The use of antifibrinolytics, especially tranexamic acid (TXA), to mitigate intraoperative blood loss has increased in popularity. The goal of this quality improvement project was to evaluate provider compliance with a TXA dosing protocol during pediatric corrective spine procedures. A retrospective chart review was conducted to compare pre- and postimplementation data on cell saver and packed red blood cell (PRBC) administration and dose of antifibrinolytic administered. A total of 486 patients (68% idiopathic and 32% neuromuscular) were evaluated over a 9-year period. Following implementation of the protocol, patients of idiopathic origin experienced a 20% reduction in cell saver administration, a 10% reduction in PRBC administration, and a 37% increase in provider compliance with the dosing protocol. Patients of neuromuscular origin experienced a 53% increase in provider compliance with the recommended TXA dosing protocol; however, this patient population did not experience a statistically significant reduction in transfusion requirements. Implementation of an antifibrinolytic protocol can facilitate compliance with recommended TXA dosing parameters and potentially decrease intraoperative blood loss, reducing blood product transfusion requirements., Competing Interests: Name: Katherine D. Jones, DNP, CRNA Contribution: This author has made significant contributions to the conception, analysis of case reports, and the preparation, editing, and revision of the manuscript to justify inclusion as an author. Disclosures: None. Name: Cameron Hatlevig, DNP, CRNA Contribution: This author has made significant contributions to the conception, analysis of case reports, and the preparation, editing, and revision of the manuscript to justify inclusion as an author. Disclosures: None. Name: Julie A. Thompson, PhD Contribution: This author helped analyze the gathered data, create reports, and edit, and revise the manuscript to justify inclusion as an author. Disclosures: None. Name: Beau Rowe, DNP, CRNA Contribution: This author provided critical edits and revisions to the manuscript to justify inclusion as an author. Disclosures: None. Name: Lisa M. Einhorn, MD Contribution: This author played a significant role in analyzing the case reports and in the preparation, editing, and revision of the manuscript, making significant contributions throughout the process to justify inclusion as an author. Disclosures: None Name: Emily M. Funk, DNP, CRNA Contribution: This author made significant contributions to the project conception and facilitation data analysis, as well as the preparation, editing, and revision of the manuscript to justify inclusion as an author. She is the corresponding author of this article. Disclosures: None The authors did not discuss off-label use within the article. Disclosure statements are available upon request., (Copyright © 2024 by the American Association of Nurse Anesthesiology.)