Transfusion clinique et biologique : journal de la Societe francaise de transfusion sanguine最新文献

Background and objectives: Reports on the changes in plasma fibrinogen levels in patients receiving cryoprecipitates synthesized using different methods are lacking. Therefore, we investigated these changes in patients who underwent cardiovascular surgery.

Materials and methods: We included 309 patients who underwent cardiovascular surgery and received 12 cryoprecipitate units between February 2020 and March 2024 and 204 patients were selected by propensity score matching. The cryoprecipitates were prepared using two methods. Fresh frozen plasma (FFP) was thawed at 2 to 6 °C for 24 h and centrifuged to remove the supernatant in the one-step method, whereas FFP was thawed, refrozen at -20 °C, and subsequently rethawed in the two-step method. We investigated the association between different cryoprecipitate preparation methods and ICU admission for ≥1 week, with in-hospital mortality considered as a competing risk in the analysis. In addition, we evaluated the changes in plasma fibrinogen levels before and after cryoprecipitate administration.

Results: Baseline plasma fibrinogen levels were significantly higher in the two-step method group than in the one-step method group. Differences in cryoprecipitate preparation methods were not significantly associated with ICU admission for ≥1 week, in the analysis that considered in-hospital mortality as a competing risk (P = 0.93). The increase in plasma fibrinogen levels after cryoprecipitate administration was significantly higher with the two-step method than with the one-step method (36 mg/dL vs. 51 mg/dL, P = 0.020).

Conclusion: The cryoprecipitates synthesized using the two-step method showed a higher increase in plasma fibrinogen levels than those prepared using the one-step method. These findings may help guide appropriate transfusion protocols by confirming intraoperative plasma fibrinogen levels.

Background and objectives: Assessing the quality of blood donation drives is imperative for maintaining blood safety. Currently, there are no validated tools for evaluating the Outdoor Blood Donation Drive (OBDD). This study intends to develop and validate a quality assessment tool for OBDD in India.

Materials and methods: This cross-sectional study was conducted over 12 months at a tertiary-care blood centre in India. Three phases of the study were tool development and validation, OBDD quality assessment, and mini-tool development. Internal consistency was assessed using Cronbach's alpha. Spearman's correlation matrix assessed variable correlations' direction and strength. Psychometric tests, including Bartlett's sphericity test and Kaiser-Meyer-Olkin score, were used. For factor analysis, Principal Axis Factoring with Oblimin rotation was utilized.

Results: A 30-item questionnaire was developed to assess OBDD quality. The tool had high content validity (mean I-CVI: 0.93) and reliability (Cronbach's alpha: 0.89). Out of 100 ODBB assessed, around 67 % scored Grade B and 17 % scored Grade C. Scores were low for aspects such as display of IEC materials, restroom facility, grade of registration, grade of collection, and pre-drive awareness. Following an iterative process based on the KMO Measure of Sampling Adequacy (MSA), communality values, and factor loadings, a 15-item tool was developed. The Cronbach's alpha of the tool was 0.80, denoting good internal consistency.

Conclusion: The developed comprehensive and mini quality assessment tool, comprising 30 and 15 parameters, was found valid and reliable. This can be adapted as per the required customisation across blood centres globally.

Background and objectives: Efficient workflow in blood donation centers is crucial for timely collections, donor safety, and effective staff utilization. However, issues such as redundant documentation, inefficient layouts, communication interruptions, and inventory disruptions often lead to increased donor waiting times and decreased satisfaction. To address these inefficiencies, a study was conducted employing Lean Six Sigma (LSS) methodology to identify and reduce non-value-added activities (NVA) in the donor area.

Materials and methods: Utilizing the DMAIC (Define-Measure-Analyze-Improve-Control) framework over seven months, the study involved baseline observations, time-motion studies, staff interviews, and spaghetti diagrams to uncover bottlenecks. Targeted interventions included workflow zoning, digital registration, inventory dashboards, structured communication protocols, and role delegation. The quantitative outcomes were measured pre- and post-intervention (October-December 2024 vs. January-April 2025) were performed using SPSS software (version 29).

Results: The results demonstrated a statistically significant improvement in post-intervention: donor registration time reduced by 52.7 %, waiting times decreased by 49.6 %, and NVA activities dropped from 20 % to 9 % of staff time. Documentation errors fell by 65 %, inventory disruptions decreased to under 10 min per day, and staff movement dropped by over 40 %. Additionally, donor throughput increased by 25 %, and satisfaction scores improved from 61 % to 86 %, while communication delays were reduced from over 90 min to 25-30 min daily demonstrating a significant large-sized effect with meaningful difference.

Conclusion: The application of LSS significantly enhanced workflow efficiency, documentation accuracy, and service delivery, presenting a scalable and sustainable model for quality improvement in healthcare settings.