Effect of pharmacy management on turnaround time of 4-factor prothrombin complex concentrate

The change in turnaround time of 4-factor prothrombin complex concentrate (PCC) when managed by the pharmacy department compared to blood bank management was evaluated.

A retrospective analysis evaluated blood bank versus pharmacy management of PCC. Blood bank management was evaluated from November 2014 to November 2015, and pharmacy management was evaluated from December 2015 to July 2016. Chart review was performed on all patients who received PCC during these study periods. The primary outcome was the difference in median time from order entry to administration between management groups. Comparisons were made for the appropriateness of clinical use, length of stay, and discharge status. The primary outcome was analyzed using a Mann-Whitney U test. Secondary outcomes were analyzed using the chi-square test or Fisher's exact test. Descriptive statistics were utilized to analyze secondary outcomes.

Forty-three patients received PCC in the blood bank group, and 22 patients received PCC in the pharmacy group. Median turnaround time of PCC was lower in the pharmacy group (43 minutes; interquartile range [IQR], 32-65 minutes) compared to the blood bank group (62 minutes; IQR; 39-110 minutes; p = 0.032). PCC use was clinically appropriate for 55% of patients (n = 12) in the pharmacy group compared with 37% of patients (n = 16) in the blood bank group (p = 0.182). There were no significant differences between the blood bank and pharmacy groups with regard to hospital length of stay or in-hospital mortality.

Conversion of PCC management from the blood bank to the pharmacy was associated with a significant decrease in time to PCC administration.