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Related Experiment Video

Updated: Jan 22, 2026

Routine Screening Method for Microparticles in Platelet Transfusions
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Restrictive Transfusion Strategy and Clinical Decision Support Practices for Reducing RBC Transfusion Overuse.

James H Derzon1, Nicole Clarke2, Aaron Alford3

  • 1RTI International, Research Triangle Park, NC.

American Journal of Clinical Pathology
|July 16, 2019
PubMed
Summary

Implementing a restrictive transfusion strategy and using computerized physician order entry/clinical decision support (CPOE/CDS) tools effectively reduce red blood cell (RBC) transfusions in adult patients. Both practices show high-strength evidence of effectiveness.

Keywords:
Clinical decision supportComputerized physician order entryMeta-analysisRBC transfusionRestrictive transfusion strategySystematic review

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Area of Science:

  • Evidence-based medicine
  • Health informatics
  • Transfusion medicine

Background:

  • Red blood cell (RBC) transfusions are common but can be overused.
  • Identifying effective strategies to optimize transfusion practices is crucial for patient safety and resource management.

Purpose of the Study:

  • To assess the effectiveness of restrictive transfusion strategies.
  • To evaluate the impact of computerized physician order entry/clinical decision support (CPOE/CDS) tools on reducing RBC transfusions.
  • To synthesize evidence for adult surgical and nonsurgical patients.

Main Methods:

  • Systematic review following the Centers for Disease Control and Prevention Laboratory Medicine Best Practice (LMBP) method.
  • Assessment of study quality and evidence of effectiveness in reducing RBC transfusions.
  • Inclusion of studies on restrictive transfusion practices and CPOE/CDS tools.

Main Results:

  • Twenty-five studies supported restrictive transfusion practices.
  • Seven studies supported CPOE/CDS tools.
  • High strength of evidence was found for both strategies in reducing RBC transfusions.

Conclusions:

  • Adherence to institutional restrictive transfusion strategies is effective in reducing RBC transfusion overuse.
  • Utilizing CPOE/CDS tools, such as hemoglobin alerts, enhances adherence to restrictive transfusion policies.
  • Both strategies are proven effective in optimizing RBC transfusion practices.