title: Improving transfusion practices in a busy teaching hospital.
abstract: A retrospective audit of blood transfusions was carried out in Cardiff Royal Infirmary (CRI) to investigate how efficiently blood was requested and used by the various clinical directorates. Excessive crossmatch/transfusion (C/T) ratios were found for a number of operations. In an attempt to improve practices, a pilot study was carried out between the Department of Haematology and the largest single requesting group, the Orthopaedic Directorate. As a result of a preliminary retrospective audit, crossmatch guidelines were revised, with more reliance on the group and antibody screen (G & S) for low-risk operations. A subsequent prospective audit showed major reductions in crossmatch requests and a general decrease in C/T ratios to very efficient levels without any patient morbidity. Blood was freed for urgent use elsewhere, and significant cost improvements resulted. This study, using the orthopaedic surgery department as a model, shows the value of inter-departmental audit and supports the experience of other centres using similar methods to make considerable savings in the amount of blood crossmatched unnecessarily.
authors.affiliation: Department of Orthopaedics, Cardiff Royal Infirmary, Wales, UK.
authors.forename: R L
authors.initials: RL
authors.lastname: Williams
authors.forename: D
authors.initials: D
authors.lastname: McLellan
authors.forename: S
authors.initials: S
authors.lastname: Lees
authors.forename: D
authors.initials: D
authors.lastname: Dunlop
mesh_terms: D001771:Blood Banks / Q000458:organization & administration*; D001803:Blood Transfusion / Q000191:economics / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching; D006801:Humans; D008485:Medical Audit; D010865:Pilot Projects; D011446:Prospective Studies; D012189:Retrospective Studies; D014852:Wales