Related Experiment Video
Updated: Mar 27, 2026
A Precision Medicine Tool for Measurement and Monitoring of Hemoglobin S in Sickle Cell Disease Patients Receiving Transfusion Therapy
Reduction of red blood cell transfusions by implementation of a concise pretransfusion checklist
A J van Gammeren1, M M C Haneveer1, R Slappendel2
1Department of Clinical Chemistry and Haematology, Amphia Hospital, Breda, the Netherlands.
Insights
Implementing a pretransfusion checklist significantly reduced red blood cell use and costs. This restrictive blood transfusion strategy also shortened patient hospital stays, demonstrating its effectiveness.
Area of Science:
- Transfusion Medicine
- Healthcare Management
- Patient Safety
Background:
- Assesses the impact of a concise pretransfusion checklist on restrictive blood transfusion strategies.
- Highlights the need for optimized red blood cell utilization and prevention of transfusion overdosing.
Purpose of the Study:
- To evaluate the effectiveness of a decision support algorithm implemented via a pretransfusion checklist.
- To optimize the use of red blood cells and prevent transfusion-related overdosing.
Main Methods:
- Physicians required to complete a checklist with pretransfusion patient data for approval.
- Laboratory personnel verified checklist information before approving transfusion requests.
- Analysis of red blood cell transfusion events, length of stay, and mortality pre- and post-implementation.
Main Results:
- A 17.0% decrease in transfusion requests and a 22.6% reduction in red blood cell units used.
- Significant cost savings of €190,000 annually and a 1.07-day reduction in median patient length of stay.
- Modest, statistically significant decreases in pre- and post-transfusion hemoglobin levels, indicating appropriate transfusion practices.
Conclusions:
- A concise checklist as decision support for transfusion necessity is a successful restrictive blood transfusion strategy.
- The implemented checklist effectively reduced red blood cell consumption and associated costs.
- This checklist-based approach is adaptable for use in other healthcare settings.
Background:
This study assesses the effect of the implementation of a concise pretransfusion checklist as a means for restrictive blood transfusion strategy.
Objectives:
To achieve an optimal use of red blood cells and to prevent overdosing of transfusion by implementation of a decision support algorithm.
Methods:
To ensure adequate use of red blood cells, physicians were obliged to complete the checklist with pretransfusion patient information before transfusion was approved. Laboratory employees checked the information and provided approval or refused to process the request. The red blood cell transfusion events, length of stay and mortality were analysed during a pre- and post-implementation period of 1 year.
Results:
Transfusion requests decreased by 17·0%. The proportion of 1-unit and 2-unit transfusions decreased by 5·6% and 29·2%, respectively, corresponding with a total red blood cell units reduction of 22·6% and a yearly direct local cost reduction of 190·000 €. The median length of stay of transfused patients on wards decreased by 1·07 days (P < 0·05). Average pre- and post-transfusion haemoglobin levels before and after implementation of the checklist decreased by 0·32-0·35 g L(-1) (P < 0·05) for one unit red blood cell transfusions and 0·72-0·87 g L(-1) (P < 0·05) for two units of red blood cell transfusions.
Conclusion:
Decision support for transfusion necessity, in the form of a concise checklist as part of the transfusion request, is an example of a successful restricted blood transfusion strategy. The checklist can be applied in other hospitals as well.
Related Concept Videos
01:15Blood Transfusion
Blood Transfusion Overview
A blood transfusion is a medical procedure used to replace blood lost due to injury, surgery, or to treat conditions such as anemia or cancer. During a transfusion, donor blood is...
02:45Blood Transfusion and Agglutination
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
01:22Bone Marrow Sampling and Transplants
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
01:19Rh Blood Group
01:28Kidney Transplant I: Introduction