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Blood audit evidenced-based cross-match requesting for lumbar spine surgery
Andrew Clarke1, Michael O'Malley, James F Hegarty
1Department of Trauma and Orthopaedic Surgery, Derriford Hospital, Plymouth, UK. kluver_bucy@hotmail.com
Spine
|May 25, 2006
Summary
Implementing evidence-based blood ordering protocols in spinal surgery significantly reduced unnecessary blood cross-matches. This optimization conserves blood products and improves resource management.
Area of Science:
- Transfusion Medicine
- Healthcare Management
- Surgical Practices
Background:
- Spinal surgeons historically ordered blood products based on practice rather than evidence.
- Blood is a scarce resource, with donor populations reduced due to variant Creutzfeldt-Jakob disease risks.
- Clinicians bear the responsibility for optimizing blood product management.
Purpose of the Study:
- To radically overhaul blood ordering practices within a spinal surgery department.
- To maximize the efficient use of blood products through evidence-based protocols.
Main Methods:
- A complete audit cycle was performed on elective lumbar spine operations (2002-2003).
- Data from the spinal surgery and blood transfusion departments were cross-referenced.
- Cross-match to transfusion (C:T) ratios and transfusion indexes (TI) were calculated, followed by prospective auditing of a new protocol.
Main Results:
- Initial audit showed 664 cross-match requests with only 40 units transfused (C:T ratio of 16.6:1).
- Prospective audit of the new protocol resulted in 58 units cross-matched and 5 transfused (C:T ratio of 11.5:1).
- Significant reduction in blood product wastage was achieved.
Conclusions:
- Implementing evidence-based cross-match protocols can lead to substantial savings.
- Optimized protocols reduce time, manpower, and financial costs associated with blood product management.
- This approach enhances the efficient use of scarce blood resources.
