Effects of introducing Type&Screen system on rational use of transfusions

Introduction: The number of blood donors at the global level has decreased primarily due to ethical and age-related changes in the structure of the planet's population. In addition, there is over ordering of blood for surgical patients. Accordingly, there is a need for rationalizing the testing...

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Autores principales:	Stefanović Aleksandar O., Čolak Emina S., Stanojević Gordana D., Nikolić Ljubinka I.
Formato:	article
Lenguaje:	EN SR
Publicado:	Srpsko lekarsko drustvo 2021
Materias:	transfusion indexes cross-match blood blood group boq ctr ti Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/2bd7fc40ef8b4e7385e9b86d0d22de9c
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spelling	oai:doaj.org-article:2bd7fc40ef8b4e7385e9b86d0d22de9c2021-12-05T21:22:02ZEffects of introducing Type&Screen system on rational use of transfusions2334-949210.5937/hpimj2102051Shttps://doaj.org/article/2bd7fc40ef8b4e7385e9b86d0d22de9c2021-01-01T00:00:00Zhttps://scindeks-clanci.ceon.rs/data/pdf/2334-9492/2021/2334-94922102051S.pdfhttps://doaj.org/toc/2334-9492Introduction: The number of blood donors at the global level has decreased primarily due to ethical and age-related changes in the structure of the planet's population. In addition, there is over ordering of blood for surgical patients. Accordingly, there is a need for rationalizing the testing i.e. reducing the number of cross-matchings and decrease in the use of blood. A type and screen (T&S) upon admission is sufficient for most patients. Determination of ABO blood group and Rh type, and screens for clinically significant alloantibodies is denoted as type and screen (T&S). Aim: Comparison of pharmaco-economic effect using transfusion indices on the number of performed cross-matches and the amount of packed red blood cells issued. Material and Methods: The authors present the comparison between the year 2010 before the introduction of the Type and Screen (T&S) system and the year 2019 when the T&S system and restrictive policy in transfusion practice, were introduced. Data for 2010 were collected from written transfusion protocols of the clinic, and for 2019 were obtained from the hospital information system (Heliant) and written transfusion protocols. The difference between two groups of data was examine with Chi-square test and Fisher exact test, with the reliability level set at p<0.05. Results: With the introduction of the T&S system, the number of cross-matches was reduced from 0.63 to 0.49 and the number of blood units was reduced from 0.21 to 0.11 per hospitalized patient, which at the level of one clinic represents a significant pharmacoeconomic contribution of approximately 50%. In our study, after processing T&S in ordering of blood, the indices (CTR, %T, TI) failed to improve. Despite of unsatisfactory transfusion indices, the application of restrictive indication policies in accordance with national and international guidelines has led to highly significant reduction in the consumption of total blood from 3243 to 1867 blood units. The BOQ as an overall assessment of the results after the introduction of the T&S procedure indicated improvement. Conclusions: The introduction of validation in blood transfusion indirectly draws the attention of prescribing physicians to take into account the significance of blood therapy. The effects of the introduction of the T&S method and restrictive transfusion policy are savings in blood consumption, decreased number of patients tested, a significant reduction in used blood units, and the number of performed cross-matches, despite the increased number of patients.Stefanović Aleksandar O.Čolak Emina S.Stanojević Gordana D.Nikolić Ljubinka I.Srpsko lekarsko drustvoarticletransfusion indexescross-matchbloodblood groupboqctrtiTherapeutics. PharmacologyRM1-950ENSRHospital Pharmacology, Vol 8, Iss 2, Pp 1051-1057 (2021)
institution	DOAJ
collection	DOAJ
language	EN SR
topic	transfusion indexes cross-match blood blood group boq ctr ti Therapeutics. Pharmacology RM1-950
spellingShingle	transfusion indexes cross-match blood blood group boq ctr ti Therapeutics. Pharmacology RM1-950 Stefanović Aleksandar O. Čolak Emina S. Stanojević Gordana D. Nikolić Ljubinka I. Effects of introducing Type&Screen system on rational use of transfusions
description	Introduction: The number of blood donors at the global level has decreased primarily due to ethical and age-related changes in the structure of the planet's population. In addition, there is over ordering of blood for surgical patients. Accordingly, there is a need for rationalizing the testing i.e. reducing the number of cross-matchings and decrease in the use of blood. A type and screen (T&S) upon admission is sufficient for most patients. Determination of ABO blood group and Rh type, and screens for clinically significant alloantibodies is denoted as type and screen (T&S). Aim: Comparison of pharmaco-economic effect using transfusion indices on the number of performed cross-matches and the amount of packed red blood cells issued. Material and Methods: The authors present the comparison between the year 2010 before the introduction of the Type and Screen (T&S) system and the year 2019 when the T&S system and restrictive policy in transfusion practice, were introduced. Data for 2010 were collected from written transfusion protocols of the clinic, and for 2019 were obtained from the hospital information system (Heliant) and written transfusion protocols. The difference between two groups of data was examine with Chi-square test and Fisher exact test, with the reliability level set at p<0.05. Results: With the introduction of the T&S system, the number of cross-matches was reduced from 0.63 to 0.49 and the number of blood units was reduced from 0.21 to 0.11 per hospitalized patient, which at the level of one clinic represents a significant pharmacoeconomic contribution of approximately 50%. In our study, after processing T&S in ordering of blood, the indices (CTR, %T, TI) failed to improve. Despite of unsatisfactory transfusion indices, the application of restrictive indication policies in accordance with national and international guidelines has led to highly significant reduction in the consumption of total blood from 3243 to 1867 blood units. The BOQ as an overall assessment of the results after the introduction of the T&S procedure indicated improvement. Conclusions: The introduction of validation in blood transfusion indirectly draws the attention of prescribing physicians to take into account the significance of blood therapy. The effects of the introduction of the T&S method and restrictive transfusion policy are savings in blood consumption, decreased number of patients tested, a significant reduction in used blood units, and the number of performed cross-matches, despite the increased number of patients.
format	article
author	Stefanović Aleksandar O. Čolak Emina S. Stanojević Gordana D. Nikolić Ljubinka I.
author_facet	Stefanović Aleksandar O. Čolak Emina S. Stanojević Gordana D. Nikolić Ljubinka I.
author_sort	Stefanović Aleksandar O.
title	Effects of introducing Type&Screen system on rational use of transfusions
title_short	Effects of introducing Type&Screen system on rational use of transfusions
title_full	Effects of introducing Type&Screen system on rational use of transfusions
title_fullStr	Effects of introducing Type&Screen system on rational use of transfusions
title_full_unstemmed	Effects of introducing Type&Screen system on rational use of transfusions
title_sort	effects of introducing type&screen system on rational use of transfusions
publisher	Srpsko lekarsko drustvo
publishDate	2021
url	https://doaj.org/article/2bd7fc40ef8b4e7385e9b86d0d22de9c
work_keys_str_mv	AT stefanovicaleksandaro effectsofintroducingtypescreensystemonrationaluseoftransfusions AT colakeminas effectsofintroducingtypescreensystemonrationaluseoftransfusions AT stanojevicgordanad effectsofintroducingtypescreensystemonrationaluseoftransfusions AT nikolicljubinkai effectsofintroducingtypescreensystemonrationaluseoftransfusions
_version_	1718370992381755392

Effects of introducing Type&Screen system on rational use of transfusions

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