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A clinical audit on the practice of platelet transfusions at a tertiary paediatric referral centre
1Department of Paediatrics, Hospital Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia.
Insights
An audit found that 18.5% of platelet transfusions were inappropriate due to a lack of clear clinical practice guidelines. Developing detailed local guidelines is recommended to improve transfusion appropriateness and patient care.
Area of Science:
- Hematology
- Clinical Pathology
- Quality Improvement in Healthcare
Background:
- Platelet transfusions are vital for managing thrombocytopenia and other bleeding disorders.
- Inconsistent clinical practice can lead to inappropriate platelet utilization.
- Establishing clear guidelines is essential for quality transfusion medicine.
Purpose of the Study:
- To audit the appropriateness of platelet transfusion indications at the Paediatric Institute, Kuala Lumpur Hospital.
- To identify areas for improvement in platelet transfusion practices.
- To assess the need for localized clinical practice guidelines.
Main Methods:
- A prospective audit was conducted over one month.
- Retrospective data from the preceding month were collected for comparison.
- A predefined set of criteria, agreed upon by an audit committee, was used to evaluate transfusion appropriateness.
Main Results:
- Out of 119 cases reviewed, 18.5% (22 cases) demonstrated inappropriate indications for platelet transfusion.
- The audit highlighted variability in current transfusion practices.
Conclusions:
- There is a significant incidence of inappropriate platelet transfusions.
- A need exists for more detailed, locally relevant clinical practice guidelines.
- Implementing specific guidelines can reduce inappropriate platelet transfusions and optimize resource use.
Abstract:
Platelet transfusions are indicated in a wide variety of clinical conditions especially those with thrombocytopenia. However, without proper clinical practice guidelines, inappropriate transfusions are bound to happen. To ascertain the provision of a quality and appropriate practice of platelet transfusions, an audit study was carried out over a period of one month at the Paediatric Institute, Kuala Lumpur Hospital. A prospective audit was performed during that period whilst a retrospective collection of data was carried out for the previous month for comparison. Based on a set of criteria agreed upon by the audit committee, it was found that in 18.5% (22 of 119) of the cases, the indications for platelet transfusions were inappropriate. The audit committee concluded that there is a need for a more detailed clinical practice guideline for local use to reduce or lower the incidence of inappropriate transfusions of platelets.