title: Prospective audit of cytomegalovirus-negative blood product utilization in haematology/oncology patients.
abstract: The transfusion management of immunocompromised patients often requires special blood product use such as cytomegalovirus (CMV)-negative cellular products, which are more costly than standard blood products and occasionally in short supply. We audited the use of CMV-negative products in haematology/oncology patients to determine the appropriateness of their use. A concurrent-prospective audit was conducted of all orders for CMV-negative packed red blood cell (PRBC) and platelet products in 201 haematology/ oncology patients. Once CMV serostatus was determined, orders for inappropriate CMV-negative units were cancelled, and filled as CMV untested units. During the 21-month period of this audit, the rates of inappropriate transfusions decreased for PRBC from 73.2% to 14.3% (chi2 = 68.4, P<0.001) and for platelets from 68.1% to 10.6% (chi2 = 65.6, P<0.001). The median time to cancellation of inappropriate CMV-negative orders was 11 days. This audit resulted in estimated cost savings of $16500 over the 21-month duration. Inappropriate requests for scarce and expensive blood products are substantially reduced by concurrent-prospective auditing of transfusion practice, in a manner that is both simple and cost effective.
authors.affiliation: The Toronto Hospital and University of Toronto, The Canadian Blood Services, Toronto Centre, Ontario.
authors.forename: H
authors.initials: H
authors.lastname: Chang
authors.forename: J
authors.initials: J
authors.lastname: Hawes
authors.forename: G A
authors.initials: GA
authors.lastname: Hall
authors.forename: K
authors.initials: K
authors.lastname: Fuller
authors.forename: W H
authors.initials: WH
authors.lastname: Francombe
authors.forename: E
authors.initials: E
authors.lastname: Zuber
authors.forename: G D
authors.initials: GD
authors.lastname: Sher
mesh_terms: D000914:Antibodies, Viral / Q000097:blood; D001769:Blood / Q000821:virology*; D001803:Blood Transfusion / Q000191:economics / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D003587:Cytomegalovirus / Q000276:immunology / Q000302:isolation & purification*; D017707:Erythrocyte Transfusion / Q000191:economics / Q000706:statistics & numerical data; D006402:Hematologic Diseases / Q000628:therapy*; D006801:Humans; D016867:Immunocompromised Host; D008485:Medical Audit; D009369:Neoplasms / Q000628:therapy*; D017713:Platelet Transfusion / Q000191:economics / Q000706:statistics & numerical data; D011446:Prospective Studies
chemical_list: D000914:Antibodies, Viral