Vol 54, No 6 (2023)
Original research article
Published online: 2023-11-29

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Effectiveness of blood utilization across departments in a tertiary health institution

Ikechukwu Okwudili Anigbogu1, Ebele Dumebi Muoghalu2, Anazoeze Jude Madu1, Charles Emeka Nonyelu1, Helen Chioma Okoye1, Angela Ogechukwu Ugwu1, Augustine Nwakuche Duru1, Chinedu Ezekekwu2
Acta Haematol Pol 2023;54(6):411-416.

Abstract

Intruduction: The limited availability of blood makes it imperative that Hospitals and transfusion centres employ blood utilization indicators to ensure effective and efficient use. This study is a review of the transfusion practices and blood utilization Indicators of the largest tertiary health centre in South East Nigeria.

Material and methods: The study is a retrospective cross-sectional Hospital based type. The following, biodemographic data, clinical diagnosis, and blood bank information such as patient and donor blood types from a 3-year period (January 2018–January 2021) was reviewed. The total number of units crossmatched, issued, transfused, or returned was extracted. Utilization Indicators such as crossmatch to transfusion ratio, transfusion probability, and transfusion index were calculated and our findings were compared to similar studies performed in centres located in India, Ethiopia and Saudi Arabia

Results: A total of 2,919 blood units were cross-matched out of which 2,212 units were transfused to 1,953 patients. The study reported an overall crossmatch to transfusion rate of 1.3, a Transfusion probability of 71%, and a transfusion index of 1.1. These findings compare favourably with findings reported from studies done in other LMIC countries. Comparatively, the Department of Medicine with a crossmatch to transfusion ratio of 1.1 has the most efficient blood ordering practices.

Conclusion: The study findings showed that the quality indicators on the utilization of blood are in keeping with international best practices. Implementation of policies like the Maximum surgical blood ordering schedule (MSBOS) could further strengthen the practice and improve the results of the surgical disciplines.

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References

  1. Savage W. Implementing a blood utilization program to optimize transfusion practice. Hematology Am Soc Hematol Educ Program. 2015; 2015: 444–447.
  2. Shash H, Alabdulqader R, Alshehri L, et al. Blood utilization and quality indicators at a university hospital in the Eastern Province of Saudi Arabia. PLoS One. 2022; 17(4): e0267449.
  3. Zewdie K, Genetu A, Mekonnen Y, et al. Efficiency of blood utilization in elective surgical patients. BMC Health Serv Res. 2019; 19(1): 804.
  4. Karaca B, Namdaroglu S, Ari A, et al. Crossmatch to transfusion ratio as a new quality indicator in blood banking. J Hematol Transfus. 2020; 7(1): 1085.
  5. Virk MS. Crossmatch to transfusion ratios in the operating room with an expanding hospital footprint. Am J Clin Pathol. 2021; 156(Suppl_1): S159.
  6. Boral LI, Henry JB. The type and screen: a safe alternative and supplement in selected surgical procedures. Transfusion. 1977; 17(2): 163–168.
  7. Mead JH, Anthony CD, Sattler M. Hemotherapy in elective surgery: an incidence report, review of the literature, and alternatives for guideline appraisal. Am J Clin Pathol. 1980; 74(2): 223–227.
  8. Mwambungu A, Siulapwa N, Mugala D, et al. Analysis of blood cross-match ordering practice in surgical patients at Ndola Central Hospital. International Journal of Healthcare Sciences. 2015; 3(1): 278–284.
  9. Belayneh T, Messele G, Abdissa Z, et al. Blood requisition and utilization practice in surgical patients at university of gondar hospital, northwest ethiopia. J Blood Transfus. 2013; 2013: 758910.
  10. Ibrahim SZ, Mamdouh HM, Ramadan AM. Blood utilization for elective surgeries at Main University Hospital in Alexandria, Egypt. J Am Sci. 2011; 7(6): 683–689.
  11. WHO model list of essential medicines — 22nd list, 2021. https://www.who.int/publications/i/item/WHO-MHP-HPS-EML-2021.02 (September 30, 2021).
  12. Goodnough LT. Blood management: transfusion medicine comes of age. Lancet. 2013; 381(9880): 1791–1792.
  13. Goodnough LT, Shah N. The next chapter in patient blood management: real-time clinical decision support. Am J Clin Pathol. 2014; 142(6): 741–747.
  14. Ugwu AO, Madu AJ, Anigbogu IO. Blood transfusion in Sub Saharan Africa: historical perspectives, clinical drivers of demand and strategies for increasing availability. Africa Sanguine. 2021; 23(1): 14–17.
  15. Yasmeen I, Ahmed I, Bashir S. Efficiency of blood utilization and characteristics of patients receiving blood transfusion at an associated hospital in North India. Int J Res Med Sci. 2021; 9(4): 1056.
  16. Feyisa T, Tesfaye Kiya G, Maleko WA. Assessment of recipients' characteristics, transfusion appropriateness, and utilization pattern of blood and blood products in Jimma Medical Center, Jimma, Ethiopia. PLoS One. 2021; 16(4): e0250623.
  17. Tewabe H, Mitiku A, Worku H. Assessment of blood transfusion utilization and patient outcomes at Yekatit-12 Hospital, Addis Ababa, Ethiopia. J Blood Med. 2022; 13: 171–180.
  18. Shaikh OH, Bhattarai S, Shankar VG, et al. Blood ordering and utilization in patients undergoing elective general surgery procedures in a tertiary care hospital: a prospective audit. Natl Med J India. 2022; 35(2): 68–73.
  19. Akshat K, Gita N, Dushyant Singh G, et al. Blood utilization practices in elective surgical patients in a Tertiary Care Hospital of Uttarakhand. Glob J Transfus. 2016; 1(2): 51–56.
  20. Trisal M, Rana S, Khetrapal S, et al. Blood utilization and quality indicators at a Tertiary Care Hospital in South Delhi. A retrospective study. National Journal of Laboratory Medicine. 2020; 9(2): 1–321.
  21. Karca B, Namdarogin S, Ari A, et al. Cross match to transfusion ratio as a new quality indicator in blood banking. J Hematol Transfus. 2020; 7(1): 1085.
  22. Akoko LO, Joseph AB. Blood utilization in elective surgery in a tertiary hospital in Dar es Salaam, Tanzania. Tanzania Journal of Health Research. 2015; 17(4).
  23. Friedman BA, Oberman HA, Chadwick AR, et al. The maximum surgical blood order schedule and surgical blood use in the United States. Transfusion. 1976; 16(4): 380–387.
  24. Global status report on blood safety and availability 2021. The status of blood collection, testing, processing and clinical transfusion around the world. https://www.who.int/publications/i/item/9789240051683 (June 14, 2022).
  25. Zachee P, Vandekerckhove P. How to implement a small blood bank in low and middle-income countries work in progress? Trop Med Surg. 2020; 8(1).