Blood utilisation in elective general surgery cases: requirements, ordering and transfusion practices.

Area of Science:

• Transfusion Medicine
• Surgical Safety
• Healthcare Management

Background:

• Over-ordering of blood is a prevalent issue in elective surgeries, leading to significant wastage.
• Current blood ordering and cross-matching practices may not be optimized for maximum blood utilization.

Purpose of the Study:

• To enhance the efficacy of the blood ordering system for elective surgeries.
• To formulate a Maximum Surgical Blood Order Schedule (MSBOS) to improve blood utilization.
• To reduce unnecessary blood wastage through optimized ordering protocols.

Main Methods:

• Evaluation of blood ordering and transfusion practices in 500 elective general surgical procedures.
• Application of indices like cross-match to transfusion ratio (C/T ratio), transfusion probability (% T), and transfusion index (TI).
• Modification of blood ordering patterns for the subsequent 150 patients based on study indices.

Main Results:

• Initial study: 1145 units crossmatched for 500 patients, with only 265 transfused, resulting in 76.86% blood wastage.
• Post-intervention: Blood wastage reduced from 76.86% to 25.26% in the next 150 patients.
• Blood utilization improved from 23.14% to 74.74% after implementing the modified ordering schedule.

Conclusions:

• Adjusting blood ordering patterns using a Maximum Surgical Blood Order Schedule (MSBOS) effectively prevents over-ordering of blood.
• The study demonstrates a successful strategy for optimizing blood resource management in surgical settings.