A Retrospective Audit of Appropriateness and Monitoring of Fresh Frozen Plasma Transfusions in A Tertiary Care Hospital
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 7
Abstract
Introduction: In spite of availability of transfusion guidelines for appropriate use of blood components, there is often unjustified and inappropriate use of blood components. The objective of the study was to audit the appropriateness and monitoring of fresh frozen plasma (FFP) transfusions in a tertiary care center. Material and Methods: A retrospective audit was conducted on 204 FFP transfusion episodes. The appropriateness of transfusion indication and amount of FFP transfused were assessed based on NHMRC guidelines. The transfusion episodes were categorized as per the clinical specialty and were further divided into appropriate and inappropriate transfusion episodes depending on whether the transfusion indication and the amount transfused were as per the guidelines. Inadequately documented transfusion episodes were also considered inappropriate. Monitoring of transfusion episodes and post-transfusion assessment of the FFP recipients was also evaluated. Results: The clinical specialty with the highest FFP transfusion episodes was cardiac surgery (27.9%). Out of 204, 95 episodes were appropriate (46.6%) and 105 were inappropriate (53.4%). The highest number of appropriate FFP transfusion episodes was from the specialty of General Medicine (70.5%). The most number of inappropriate transfusions were prescribed by the specialty of pediatric surgery (87.5%). Mildly elevated prothrombin time without bleeding and cardiac surgery without deranged coagulation was the most frequent inappropriate indications. Clinical monitoring of FFP recipients during the transfusion episode was performed in 15 out of 204 (7.3%) transfusion episodes. Post-transfusion follow-up of patients was performed in 29/204 (14.2%) patients from different clinical specialties. Conclusion: The high rate of inappropriate FFP transfusions indicates the need for strategies to improve the transfusion practices. This can be achieved through educational interventions for the clinical specialties about the rational use of blood components and through regular transfusion audits for all blood components.
Authors and Affiliations
Swarupa N Bhagwat, Jayashree H Sharma
Keywords
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