Designing and implementing a clinical decision support tool to improve compliance with NICU transfusions

Area of Science:

• Neonatal Medicine
• Health Informatics
• Pediatric Transfusion Medicine

Background:

• Infants in neonatal intensive care units (NICUs) have high rates of blood product transfusion.
• Liberal transfusion strategies carry risks, necessitating careful benefit-risk assessment.
• Electronic clinical decision support (CDS) tools reduce transfusions and costs in adults.

Purpose of the Study:

• To address non-compliance with transfusion guidelines in a NICU.
• To develop and implement an electronic health record-based CDS tool for NICU transfusions.
• To improve the timely availability of transfusion guidelines during the ordering process.

Main Methods:

• Development of an electronic health record-based CDS tool.
• Integration of the CDS tool into the NICU transfusion ordering workflow.
• Focus on both red blood cell and platelet transfusions.

Main Results:

• The study reports the development of a novel electronic transfusion CDS tool for NICU.
• This is the first known EHR-based CDS tool for both red blood cell and platelet transfusions in a NICU setting.
• The tool aims to improve guideline compliance and optimize transfusion practices.

Conclusions:

• Electronic CDS tools show promise for optimizing transfusion practices in the NICU.
• Implementing such tools can support evidence-based transfusion decisions for vulnerable infants.
• Further evaluation is needed to confirm the impact on transfusion rates and patient outcomes.