title: The effects of a computerized transfusion decision support system on physician compliance and its appropriateness for fresh frozen plasma use in a medical center.
abstract: Fresh frozen plasma (FFP) transfusion remains a significant issue for blood banks because of a lack of consensus regarding its appropriate use. To study the factors influencing physician compliance, we evaluated FFP transfusion episodes in the year 2008, using a computerized transfusion decision support system. A total of 10,926 episodes were reviewed. The demographic data, physician compliance, and therapeutic efficacy were investigated. The physician noncompliance rate was 46.5%. The highest number was ordered by the hepatobiliary division, which might be due to the high incidence of liver cirrhosis and hepatoma in Taiwan. Excluding the cases for plasma exchange and emergency surgery, 31.2% of episodes had abnormal coagulation results before transfusions. The therapeutic efficacy is statistically significant in patients with abnormal pretransfusion coagulation tests (P < .001). Computerization may be a favorable trend in medical management systems, but it should be more functional to improve medical quality.
authors.affiliation: Dept of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Sanmin District, Taiwan, ROC.
authors.forename: Chao-Sung
authors.initials: CS
authors.lastname: Chang
authors.forename: Yi-Ching
authors.initials: YC
authors.lastname: Lin
authors.forename: Yung-Chao
authors.initials: YC
authors.lastname: Wu
authors.forename: Chi-Jung
authors.initials: CJ
authors.lastname: Yeh
authors.forename: Yu Chih
authors.initials: YC
authors.lastname: Lin
mesh_terms: D000017:ABO Blood-Group System; D000046:Academic Medical Centers; D000094902:Blood Banking / Q000379:methods*; D001803:Blood Transfusion; D003299:Cooperative Behavior; D020000:Decision Support Systems, Clinical; D005260:Female; D006801:Humans; D008297:Male; D010820:Physicians; D010949:Plasma; D011216:Practice Management, Medical; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D013624:Taiwan; D016896:Treatment Outcome
chemical_list: D000017:ABO Blood-Group System