title: Implementing a patient blood management program in Norway: Where to start?
abstract: Norway has recently established a working group to implement a national patient blood management (PBM) program. Although benchmarking regarding blood usage is challenging in Norway due to legal barriers, a survey was sent to different hospitals to identify possible areas to be prioritized in the first phase of the PBM program. Among them, optimizing the patient's hemoglobin level before elective surgery and implementing electronic check-lists for the indication of transfusion when ordering blood products are two measures that may have a considerable impact on blood usage. The results of the survey also showed that patients may receive a red blood cell transfusion at hemoglobin levels that are higher than those internationally recommended. Since there are no national guidelines for the use of blood products, agreement regarding hemoglobin thresholds is essential to reduce variation in transfusion practice. To achieve these goals, the transfusion specialist plays a key role in promoting the principles behind the PBM concept at the local hospital.
authors.affiliation: Department of Immunology and Transfusion Medicine, St. Olav's Hospital, Trondheim, Norway. Electronic address: aurora.espinosa@stolav.no.
authors.forename: A
authors.initials: A
authors.lastname: Espinosa
authors.affiliation: Division of Immunology and Transfusion Medicine, Department of Laboratory Medicine, University Hospital of North Norway, Tromsø, Norway.
authors.forename: M
authors.initials: M
authors.lastname: Arsenovic
authors.affiliation: Blood Bank, Haukeland University Hospital, Bergen, Norway.
authors.forename: T
authors.initials: T
authors.lastname: Hervig
authors.affiliation: Department of Immunology and Transfusion Medicine, Haugesund Hospital, Haugesund, Norway.
authors.forename: T
authors.initials: T
authors.lastname: Sundic
authors.affiliation: Department of Immunology and Transfusion Medicine, Akershus University Hospital, Lørenskog, Norway.
authors.forename: A
authors.initials: A
authors.lastname: Aandahl
authors.affiliation: Department of Immunology and Transfusion Medicine, Innlandet Hospital Trust, Norway.
authors.forename: J
authors.initials: J
authors.lastname: Kronborg
authors.affiliation: International Consultancy in Blood Components Quality/Safety Improvement, Audit/Inspection & DDR Strategies, London, UK. Electronic address: jseghatchian@btopenworld.com.
authors.forename: J
authors.initials: J
authors.lastname: Seghatchian
mesh_terms: D017707:Erythrocyte Transfusion; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D009313:National Health Programs; D009664:Norway
chemical_list: D006454:Hemoglobins
keywords: Anemia; Blood usage; Patient blood management; Restrictive transfusion; Transfusion guidelines