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Evaluating patient blood management practices using PBM metrics in a tertiary care center
Ashna George1, Shamee Shastry1, Ganesh Mohan1
1Department of Immunohematology and Blood Transfusion, 2 - Department of Pathology Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Insights
Patient Blood Management (PBM) metrics were assessed in a tertiary care hospital, revealing adequate but improvable PBM practices. The study identified key areas for enhancing patient blood management effectiveness.
Area of Science:
- Healthcare Management
- Transfusion Medicine
- Clinical Auditing
Background:
- Patient Blood Management (PBM) metrics are vital for evaluating healthcare interventions.
- Assessing PBM indicators is crucial for effective program implementation in hospitals.
Purpose of the Study:
- To evaluate Patient Blood Management (PBM) metrics at a tertiary care referral hospital.
- To identify key performance indicators for effective PBM enforcement.
Main Methods:
- A prospective observational study involving 612 elective surgery patients.
- Developed and assessed PBM metrics covering documentation, patient evaluation, and blood ordering.
- Content validity confirmed by transfusion medicine and hematology experts; performance scored across 11 parameters.
Main Results:
- All departments conducted pre-operative anemia tests; General Surgery and Orthopaedics had the highest red cell transfusions.
- No blood wastage observed; C/T ratio was higher in General Surgery, Urology, and ENT departments.
- 44.12% of patients had pre-operative anemia; 65% received single-unit PRBC transfusions. All departments scored 17-19, indicating adequate PBM with improvement potential.
Conclusions:
- Patient Blood Management (PBM) metrics were used to critically assess current practices.
- Identified gaps and areas for improvement in PBM at the tertiary care center.
Background:
PBM metrics play a crucial role in assessing and monitoring the effectiveness of PBM programs in healthcare settings. The present study aimed to assess the indicators to achieve effective enforcement of PBM at a tertiary care referral hospital.
Subjects And Method:
A prospective observational study was conducted on patients admitted for elective surgery at a tertiary care referral centre. PBM metrics were developed and assessed for various parameters, including documentation, patient evaluation, blood ordering schedule, and appropriateness. Experts in transfusion medicine and haematology checked content validity. Eleven different parameters were analysed, and a score was assigned based on the performance. The outcome was categorized as poor, satisfactory, or good.
Results:
The study included 612 patients meeting the inclusion criteria and recruited from Orthopaedics, General Surgery, OBG, Urology, and ENT departments. All departments completed pre-operative anaemia tests, with General Surgery and Orthopaedics conducting the most red cell transfusions. During the study, all of the blood units were used, and there was no waste. The C/T ratio was greater in the Departments of General Surgery, Urology, and Otorhinolaryngology. Pre-operative anaemia was found in 44.12% of patients, 44 patients had red cell transfusions, with 65% getting single-unit PRBC transfusions. All departments received a PBM score between 17-19, showing adequate PBM but with room for improvement.
Conclusion:
The current study utilized Patient Blood Management (PBM) metrics to critically assess the existing practices and identify the key gaps and areas for improvement in a tertiary care centre.
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