Korean J Blood Transfus.  2020 Apr;31(1):43-54. 10.17945/kjbt.2020.31.1.43.

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

• Kim SY
• Bae GH
• Lee HR

• KMID: 2501116
• DOI: http://doi.org/10.17945/kjbt.2020.31.1.43

Abstract

Background
Fresh frozen plasma (FFP) has been inappropriately using in spite of limited transfusion indications. Our institution applied the transfusion indication data-entry to 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.

Keyword

Appropriate transfusion; Fresh frozen plasma; Transfusion indication data-entry; Warning pop-up; Blood utilization auditing