Impact of guideline implementation on transfusion practices in a surgical intensive care unit.

Publication/Presentation Date

12-1-2013

Abstract

BACKGROUND: Anemia is a common clinical problem in cardiac surgery patients in the postoperative period and may result in transfusion in up to 90% of this population. There is tremendous variation in transfusion rates by hospital and individual physician. It is unknown if implementation of a clinical practice guideline lowers unnecessary transfusion in hospital practices that already have a restrictive transfusion culture .

OBJECTIVE: To evaluate transfusion practice before and after implementation of a clinical practice guideline.

DESIGN: Pre/post intervention study.

SETTING: Sixteen bed surgical intensive care unit in an academic hospital.

PARTICIPANTS: Four hundred ninety-five adult patients undergoing cardiac surgery.

INTERVENTIONS: Implementation of an anemia clinical practice guideline reinforced with education and retrospective audit/feedback.

MEASUREMENTS AND MAIN RESULTS: A total of 252 pre-intervention and 243 postintervention cases were examined. Unnecessary transfusion occurred in 14.7% of pre-intervention patients and decreased to a rate of 8.1% after guideline implementation (p = 0.016).

CONCLUSIONS: This study suggests that clinical guideline implementation utilizing guideline development, education, and compliance audit/feedback may reduce unnecessary transfusion in cardiac surgery patients. A fully powered prospective trial would be necessary to validate these findings.

Volume

27

Issue

6

First Page

1189

Last Page

1193

ISSN

1532-8422

Disciplines

Medicine and Health Sciences

PubMedID

24064204

Department(s)

Department of Surgery

Document Type

Article

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