The Effect of the Transfusion Indication Verification Program on the Appropriateness of Fresh Frozen Plasma Transfusion

S. Kim, G. Bae, Hye Ryun Lee
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Abstract

a computerized order system in February 2018. Physicians should select the indication during transfusion order. In January 2019, the warning pop-up additionally applied for informing whether or not the coagulation test results correspond to FFP transfusion indications. We investigated the effects of a new applied program on the appropriateness of FFP transfusion. Methods: By comparing the appropriateness of transfusion before applying the transfusion indication data-entry, we investigated whether there were improvements of appropriateness after applying the transfusion indication data-entry and after applying the warning pop-up. We compared the percentages of performing pre-transfusion coagulation tests and transfusion among FFP requests before and after applying the warning pop-up. Results: After applying the transfusion indication data-entry, the appropriateness improved from 54.5% to 66.7%. The appropriateness of the surgery department was the lowest compared with that of the medical departments and emergency departments. The warning pop-up would be effective to induce pre-transfusion coagulation tests from surgery departments and emergency department. However, there was no further improvement in the appropriateness. Many requests from the surgery departments did not lead to transfusion. As the results of the analysis conducted by dividing each department that belonged to surgery departments, we could determine the wrong transfusion practice specific to each department. Conclusion: The transfusion indication data-entry contributed to improving the appropriateness of FFP transfusion. Department-specific education and real-time auditing are needed for further improvement. (Korean 2020;31:43-54)
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输血适应症验证程序对新鲜冷冻血浆输血适宜性的影响
2018年2月启用电脑化订餐系统。医生应在输血顺序中选择适应证。2019年1月,该提示框还用于告知凝血试验结果是否符合FFP输血指征。我们调查了一个新的应用程序对FFP输血的适宜性的影响。方法:通过比较应用输血指征数据录入前的适宜性,探讨应用输血指征数据录入后与应用提示框后的适宜性是否有改善。我们比较了在应用警告弹出框之前和之后进行输血前凝血试验和输血的FFP请求的百分比。结果:应用输血指征数据录入后,适宜性由54.5%提高到66.7%。与内科和急诊科相比,外科的适宜性最低。提示弹窗将有效地诱导外科和急诊科进行输血前凝血试验。但是,在适当性方面没有进一步的改进。许多来自外科部门的请求并没有导致输血。通过对各外科所属科室进行划分分析的结果,我们可以确定各科室具体的错误输血做法。结论:输血指征数据录入有助于提高FFP输血的适宜性。部门教育和实时审计有待进一步完善。(韩国2020;31:43-54)
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