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Effects of a CME program on physicians' transfusion practices.
A L Hull1, J Wasman, L T Goodnough
1Department of Medicine, Case Western Reserve University, Cleveland, Ohio.
Summary
Physicians often mismanaged autologous blood transfusions for orthopedic surgery patients, leading to suboptimal outcomes. A continuing medical education (CME) lecture improved blood ordering but not donation scheduling.
Area of Science:
- Transfusion Medicine
- Medical Education
- Orthopedic Surgery
Background:
- Physicians' transfusion practices for autologous blood donors undergoing elective orthopedic surgery require assessment.
- Suboptimal practices include accepting lower hematocrit levels and inadequate autologous blood requests.
Purpose of the Study:
- To assess physicians' transfusion practices in autologous blood donors.
- To evaluate the effectiveness of a continuing medical education (CME) lecture in modifying these practices.
Main Methods:
- Retrospective chart analysis of 44 autologous blood donors and 44 matched non-donors undergoing elective orthopedic surgery.
- Implementation of a CME lecture addressing identified practice gaps.
- Follow-up comparison of transfusion practices post-CME.
Main Results:
- Physicians accepted lower hematocrit levels for autologous donors and underordered blood.
- Some patients were overtransfused with their own blood; procedures were not scheduled adequately in advance for sufficient autologous donation.
- Post-CME, underordering of autologous blood decreased significantly, but donation scheduling time did not improve.
Conclusions:
- Continuing medical education can improve specific aspects of autologous blood transfusion management, such as blood ordering.
- Further interventions are needed to optimize pre-operative scheduling for adequate autologous blood donation.