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Related Experiment Videos

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.

Academic Medicine : Journal of the Association of American Medical Colleges
|November 1, 1989
PubMed
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.

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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.

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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.