Investigation of clinical blood transfusion in Yantai City

Abstract

Objective To investigate the current status of clinical blood transfusion in Yantai City from 2015 to 2016, analyze the weak links of clinical blood transfusion, and explore ways to strengthen clinical blood transfusion management. Methods Form 2015 to 2016, a total of 62 hospitals that signed blood supply agreements with the Yantai Central Blood Central Station were selected as research objects. According to the levels and charactoristics of the 62 hospitals, they were divided into tertiary general and public hospital group (n=12), secondary general and public hospital group (n=21), maternal and child health hospital group (n=5), first-class general and public hospital group (n=12), and private hospital group (n=12). In this study, primary hospitals included maternal and child health hospitals, first-class general and public hospitals and private hospitals. According to the Hospital Blood Transfusion Quality Evaluation and Assessment Form in Yantai City, on-site assessment of the infrastructure related to clinical blood transfusion in 62 hospitals was conducted. The questionnaires were used to investigate the implementaton of autologous blood transfusion in the 62 hospitals. A total of 510 clinical blood transfusion application forms and 270 clinical blood transfusion records were sampled randomly from 62 hospitals in January to June 2016, and the qualification rates of clinical blood transfusion application forms and clinical transfusion records were investigated. The chi-square test or the continuous correction chi-square test was used to compare the differences among hospitals of different groups or levels, which included proportions of hospitals evaluated by indicators of infrastructure related to clinical blood transfusion, implementaton rates of autologous blood transfusion, qualification rates of clinical blood transfusion application forms, and the composition ratio of clinical blood transfusion records of different grades. Results ① Among the 62 hospitals of this study, the proportion of hospitals that built clinical blood transfusion-related information management systems was 19.4% (12/62), proportion of hospitals that connected information with blood stations by internet was 8.1% (5/62), proportion of hospitals with separate blood transfusion department was 50.0% (31/62), proportion of hospitals participating in inter-room quality evaluation was 53.2% (33/62), proportion of hospitals that regularly organized clinical blood transfusion-related staffs to train was 77.4% (48/62), proportion of hospitals that took effective measures to evaluate reasonable clinical blood was 40.3% (25/62). The above 6 indicators of the secondary and tertiary general and public hospitals were significantly higher than those of the primary hospitals, and the differences were statistically significant (χ2=8.832, P=0.003; χ2=4.779, P=0.029; χ2=34.802, P<0.001; χ2=34.030, P<0.001; χ2=4.415, P=0.036; χ2=15.936, P<0.001). ② The total implementaton rate of autologous blood transfusion in 33 secondary and tertiary general and public hospitals in Yantai City was 51.5% (17/33). The implementaton rate of autologous blood transfusion in tertiary general and public hospital group was 83.3% (10/12), which was higher than that of 33.3% (7/21) in secondary general and public hospital group, and the difference was statistically significant (χ2=7.643, P=0.006). ③ In this study, the total qualified rate of 510 clinical blood transfusion application forms of the 62 hospitals was 82.7% (422/510). In evaluation of " Cosistency of applying for blood use and application of blood component function" , the overall difference in the qualified rates among 5 groups was statistically significant (χ2=31.141, P<0.001). ④ In this study, the total qualified rate of 270 clinical transfusion records in the 62 hospitals was 70.0% (189/270). The overall difference in composition ratios of qualified, partially qualified, and unqualified clinical blood transfusion records in 5 groups was statistically significant (χ2=66.221, P<0.001). Conclusions There is insufficient investment in clinical blood transfusion related infrastructure in hospitals at all levels in Yantai City, and the clinical blood transfusion related infrastructure of primary hospitals is relatively lagging behind. The autologous blood transfusion work and clinical blood transfusion management in some hospitals also need to be improved. The clinical blood transfusion management of some primary hospitals needs to be strengthened, and the competent authorities should strengthen the evaluation of the blood transfusion quality of these hospitals. Key words: Blood transfusion; Blood transfusion, autologous; Blood safety; Blood transfusion management; Clinical blood transfusion