title: Durability of response to a targeted intervention to modify clinician transfusion practices in a major teaching hospital.
abstract: OBJECTIVE
  To determine the durability of a successful intervention to modify clinician transfusion practices, and to compare current transfusion practices in the "intervention" hospital with those in a hospital with no intervention.
  
  
  METHODS
  Prospective, descriptive study.
  
  
  METHODS
  Two major metropolitan teaching hospitals--Royal Melbourne Hospital and Western Hospital, Footscray.
  
  
  METHODS
  Consecutive patient transfusion episodes for red cells, platelets and fresh frozen plasma (FFP).
  
  
  METHODS
  Appropriateness of transfusion according to intervention guidelines; comparison of inappropriate transfusion rates before the intervention, immediately after the intervention and 3 years after the intervention. Comparison of inappropriate transfusion rates in intervention and non-intervention hospitals.
  
  
  RESULTS
  Inappropriate transfusion rates 3 years after the intervention were 20% for red cells, 27% for platelets, and 43% for FFP. These were significantly higher than equivalent rates reported immediately after the intervention. Inappropriate transfusion rates at the non-intervention hospital were comparable (26% for red cells, 36% for platelets and 52% for FFP).
  
  
  CONCLUSIONS
  Appropriate clinician transfusion practices have proven difficult to sustain 3 years after hospital guideline generation and promotion. A "gate-keeping" role by hospital blood bank staff proved impractical in the long term.
authors.affiliation: Clinical Epidemiology and Health Service Evaluation Unit, NorthWestern Health Care Network, Melbourne, VIC.
authors.forename: S N
authors.initials: SN
authors.lastname: Tobin
authors.forename: D A
authors.initials: DA
authors.lastname: Campbell
authors.forename: N W
authors.initials: NW
authors.lastname: Boyce
mesh_terms: D001315:Australia; D016913:Blood Component Transfusion; D019983:Guideline Adherence; D006784:Hospitals, Teaching; D006801:Humans; D017410:Practice Guidelines as Topic; D011446:Prospective Studies