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Implementation of a Blood Conservation Initiative to Effectively Reduce Blood Transfusions in Cardiac Surgery
1Frontier Nursing University, Hyden, Kentucky.
Insights
Reducing blood transfusions in cardiac surgery is crucial due to increased mortality risks. This project aimed to decrease red blood cell transfusions but highlighted the need for improved evidence-based practices and team awareness.
Area of Science:
- Cardiovascular Surgery
- Transfusion Medicine
- Patient Safety
Background:
- Perioperative blood transfusions in cardiac surgery correlate with a 16% rise in mortality and increased morbid outcomes.
- Red blood cell transfusion rates in patients undergoing isolated coronary artery bypass graft surgery at the project site exceeded national benchmarks.
Purpose of the Study:
- To decrease red blood cell transfusions in cardiac surgery patients by 10% within an 8-week period.
- To enhance blood conservation awareness and promote evidence-based practices in cardiac surgery.
Main Methods:
- Implementation of a shared decision-making tool for patients.
- Utilization of the Any RBC Transfusion online risk calculator.
- Initiation of anemia protocols, chart identification, and blood conservation coordinator referrals.
Main Results:
- No significant decrease in the blood transfusion rate was observed during the project's implementation phase.
- The project successfully increased awareness of blood conservation strategies among clinical teams and leaders.
Conclusions:
- While the primary goal of reducing transfusion rates was not met, the initiative effectively raised awareness and stimulated discussions regarding evidence-based practices in blood management.
- Further strategies may be needed to achieve significant reductions in transfusion rates for cardiac surgery patients.
Abstract:
Perioperative and postoperative blood transfusions in cardiac surgery patients are associated with as much as a 16% increased risk of mortality and a significantly increased risk in morbid outcomes. At the project site, red blood cell transfusions in cardiac surgery patients undergoing isolated coronary artery bypass graft were above national benchmarks. The aim of the project was to reduce blood transfusions in cardiac surgery patients by 10% over 8 weeks. Primary interventions included engagement for the team and use of a shared decision-making tool for patients. Use of the Any RBC Transfusion online risk calculator was implemented with initiation of anemia protocol orders, chart identification, and blood conservation coordinator referral. There was no decrease in the blood transfusion rate during project implementation. However, this project heightened blood conservation awareness among team members and clinical leaders, brought attention to the need for evidence-based practice, and stimulated conversation about change.
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