Analyzing RBC Transfusion Practices Using Quality Indicators: A Retrospective Transfusion Audit.

Objectives Overordering of blood products, particularly packed red blood cells (PRBC), leads to inefficiencies and financial burdens within healthcare systems. The objective of this audit was to assess PRBC utilization practices against established quality indicators to enhance efficiency and reduce wastage in a newly established tertiary care hospital in Northern India. Materials and methods A retrospective audit was conducted in the department of transfusion medicine. Data were collected from departmental records and analyzed using various quality indicators, such as crossmatch to transfusion ratio (CTR), transfusion probability (%T), transfusion index (TI), and utilization rate (UR). Microsoft Excel was utilized for statistical calculations including range, percentage, ratio, and quality indicators. Results A total of 1,488 PRBC requisitions were received, 997 (67%) originated from various surgical specialties. The overall CTR was 1.88, with medical and surgical specialties having CTRs of 1.3 and 2.6, respectively. Overall %T was 53.8%, which in medical departments was 85% and in surgical departments was 38.5%. TI was 0.68 overall, which varied among medical (1.1) and surgical (0.48) specialties. The overall UR was 53.14%. Peri-operative blood loss (48%) and anemia (46%) were the primary indications for transfusions. Cardiothoracic and vascular surgery (CTVS), General surgery, and orthopaedics exhibited appropriate blood utilization practices, whereas ear nose and throat (ENT), pediatric surgery, urology, neurosurgery, and obstetrics and gynecology (OBGY) showed tendencies toward overordering and underutilization. Conclusion This audit highlights significant issues related to blood utilization practices, particularly overordering and underutilization in certain surgical specialties within the studied institution. While these findings underscore the potential benefits of implementing audit-driven policies to enhance efficiency and reduce wastage, the results are specific to this institution and may not be universally applicable. Further studies across multiple institutions are recommended to validate these findings and develop broader guidelines for optimizing blood utilization in healthcare systems.
Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institute Ethics Committee, Bioethics Cell, AIIMS Raebareli issued approval 2024-1-IMP-EXP-6. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.
(Copyright © 2024, Kaur et al.)