Blood use for surgical patients: a study of Scottish hospital transfusion practices

The use of an effective schedule for ordering blood for transfusion for surgical patients is the accepted standard of practice for hospital blood banks in UK hospitals. The use of maximum surgical blood ordering schedules (MSBOS) was surveyed throughout Scotland in 1992 and 1993. Twenty-seven hospitals participated in the study. Twenty-three (85%) of these 27 operated a schedule. Schedules varied between hospitals both in the way the schedules were implemented and in the amount of blood allocated to operations. The implementation of schedules was compared in three hospitals each for Caesarean section, transurethral resection of the prostate (TURP) and primary hip replacements. Adherence to the schedules averaged 76% (range 10-100%) and varied with operation, tariff, and hospitals. Blood use per operation did not depend on the amount of blood allowed by the schedule. Use of a MSBOS does not appear to influence clinical use of blood for transfusion, indicating that the gains in efficient use of laboratory resources and in safe handling of blood units can be made without compromising patient care.