title: Appropriateness of fresh-frozen plasma usage in hospital settings: a meta-analysis of the impact of organizational interventions.
abstract: BACKGROUND
  Transfusions of fresh-frozen plasma (FFP) are a worldwide ever-growing practice. The most advanced health care organizations, to guarantee high-quality standards of interventions and safe procedures, should disseminate scientific evidence for promoting the appropriateness of transfusions and reducing avoidable risks.
  
  
  METHODS
  We carried out a systematic review of scientific literature searching for studies focused on the implementation of different strategy of organizational interventions aimed at improving clinicians' practice.
  
  
  RESULTS
  Of 915 studies, 10 articles were included in our meta-analysis of risk of inappropriate transfusion after the implementation of an organizational intervention. The risk ratio of inappropriate transfusions before organizational interventions was 2.02 (95% confidence interval, 1.44-2.84) compared with after interventions.
  
  
  CONCLUSIONS
  The organizational interventions showed a positive impact on the reduction of rates of inappropriate FFP transfusion episodes.
authors.affiliation: Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy. gdamiani@rm.unicatt.it
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Damiani
authors.forename: Luigi
authors.initials: L
authors.lastname: Pinnarelli
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Sommella
authors.forename: Valentina
authors.initials: V
authors.lastname: Farelli
authors.forename: Luca
authors.initials: L
authors.lastname: Mele
authors.forename: Giacomo
authors.initials: G
authors.lastname: Menichella
authors.forename: Walter
authors.initials: W
authors.lastname: Ricciardi
mesh_terms: D001771:Blood Banks / Q000592:standards / Q000706:statistics & numerical data*; D016913:Blood Component Transfusion / Q000009:adverse effects* / Q000592:standards / Q000706:statistics & numerical data*; D006761:Hospitals / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D017063:Outcome Assessment, Health Care; D010949:Plasma; D011787:Quality of Health Care; D012307:Risk Factors