title: How appropriately is blood ordered in a rural hospital?
abstract: BACKGROUND
  Blood products are a limited resource particularly in a rural setting and their appropriate use is important to maintain patient safety and minimise costs.
  
  
  OBJECTIVE
  To assess the appropriateness of transfusion practices in a rural hospital. DESIGN/DATA SOURCES: A retrospective medical record audit of packed red blood cell (PRBC) use.
  
  
  METHODS
  A rural hospital 300 km northwest of Melbourne.
  
  
  METHODS
  All patients in Wimmera Base Hospital who had a PRBC crossmatch request from October 2010 to March 2011 inclusive.
  
  
  METHODS
  Proportion of appropriate transfusions and crossmatch to transfusion ratios.
  
  
  RESULTS
  A total of 257 patients and 657 PRBC units were cross-matched during the study period. Of these patients, 28.4% had pre-procedure (elective) cross-matches. Of the elective cross-matches, 27.4% were inappropriate, compared with 16.1% of emergency cross-matches. The cross-match to transfusion ratio (C:T) was 1.59 for emergency requests and 5.96 for elective requests. The C:T ratio was high in the surgical and obstetrics and gynaecology departments. 16.3% of all transfusions were single-unit transfusions.
  
  
  CONCLUSIONS
  Emergency requests were predominantly appropriate but a significant proportion of elective requests were inappropriate, suggesting changes in elective crossmatch request protocols, and increased education regarding ordering blood in a rural setting.
authors: Monash Medical Centre, Southern Health, Clayton, VIC, Australia. daryl_cheng@hotmail.com
authors: Daryl R
authors: DR
authors: Cheng
authors: Clare
authors: C
authors: Bajraszewski
authors: Kunal P
authors: KP
authors: Verma
authors: Alan M
authors: AM
authors: Wolff
mesh_terms: D001771:Blood Banks / Q000191:economics / Q000592:standards*; D001803:Blood Transfusion / Q000191:economics / Q000592:standards*; D006780:Hospitals, Rural / Q000592:standards*; D006801:Humans; D008485:Medical Audit; D008499:Medical Records; D012189:Retrospective Studies