Abstract

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 Background and Objectives

  Hospital blood transfusion committees supervise blood transfusion in hospitals. These committees could save time and cost by prevention of blood loss. This study was conducted to assess the performance of hospital blood transfusion committees in Tehran in 2005-2006.

  Materials and Methods

  In this retrospective study, 46 reports from 13 hospitals (9 community and 4 private) being sent to Tehran Blood Transfusion Center in 2005-2006 were assessed. All reports were assessed from the perspective of duties entrusted by Iranian Ministry of Health. These duties were classified as (1) report of blood transfusion complications, (2) statistical report of blood transfusions, (3) statistical report of blood orders from different wards of hospitals, (4) report of blood transfusion indications, (5) report of educational programs, and (6) assessment of personnel problems and equipment of blood banks.

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 Results

  Report of blood transfusion complications (77%) and report of blood transfusion indications (23%) were the most and the least reported duties, respectively. The most and the least relative frequencies for all hospitals, community, and private hospitals were 23%-77%, 33%-78% and 0%-75%, respectively. Committee reports in community hospitals were better than private ones, though the difference was not statistically significant (p>0.05). Cross match to transfusion ratio was considerable only in one hospital (3.05).

 Conclusions

  This study showed that reports of hospital blood transfusion committees in Tehran in 2005-2006 are in a relatively poor condition. This condition in private hospitals was worse than community ones. More focus on reports of blood transfusion indications seems to be necessary. Since cross match to transfusion ratio is an important performance indicator for hospitals, it should receive a higher level of attention of hospital committees.

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 Key words: Process assessment, Blood transfusion, Blood grouping and crossmatching, Iran

  Abstract

 Background and Objectives

 There are not any exact preoperative criteria to distinguish patients who need transfusion for their blood loss to be replaced. Most of reserved blood supplies remain unused after surgery. The aim of this study was to estimate the transfusion volume during elective abdominal surgery and try to reduce unnecessary storage of blood before surgeries.

 Materials and Methods

 This prospective observational study was done over 6 months in Baqiatallah Hospital to evaluate the use of blood transfusion during elective abdominal surgeries. We estimated preoperatively available cross-matched blood then, intraoperative use of blood during elective abdominal surgery was assessed.

 Results

 Out of 400 patients who underwent elective abdominal surgery, 134 (33.5%) required blood transfusion during surgery. In fact, out of 832 units of reserved blood only 212 (25.4%) were administered and the rest 620 units remained unused. Cross-match/transfusion ratio was 1.63. Preoperative hemoglobin level and surgery duration were both associated predictor variables.

 Conclusions

 It is recommended that blood order be restricted in case of most common elective abdominal surgeries. Use of blood refrigerator in surgery wards can save unused blood after surgery.

 Key words: Surgery, Blood Transfusion, Blood Grouping and Crossmatching

  Abstract

 Background and Objectives

 Clinical use of blood components seems to be inappropriate in Iran. The aim of this study was to evaluate blood utilization patterns in Rasht.

 Materials and Methods

 This was a cross-sectional descriptive study. Data about blood orders issued at day 20 of each month during the year 2007 were obtained from 5 hospitals. Data were analyzed by T-test with SPSS 15 descriptively for 491 cases. For all hospitals and wards, crossmatch/transfusion ratio (C/T) was calculated and compared separately.

 Results

 C/T=1/9 compared to the expected ratio was normal but significant differences were observed among different centers. The highest and lowest orders were from surgery (42.8%) and internal wards (7.1%), respectively. In surgical ward, the mean hemoglobin concentration of recipients was 9.03 ± 2.19 g/dl.

 Conclusions

 Packed cell utilization in Rasht was normal but not ideal. In this study, blood utilization model in obstetrics and gynecology ward was appropriate. This may suggest an active and effective blood transfusion committee in hospitals. It seems that the lack of hospital blood transfusion committees with no experienced doctors attending, lack of executive support and external audit of hospital blood bank agenda, the lack of software integration between blood centers and hospitals, the lack of type and screening for patients, and importantly free of charge blood dispensation are major obstacles in reforming blood utilization patterns, running haemovigilance system, and raising quality.

 Key words : Blood, Blood Grouping and Crossmatching, Iran

  Abstract

 Background and Objectives

 Blood transfusion plays a critical role in health system. However, one of the main problems is the excessive order of blood in teaching hospitals. The aim of the study was to investigate the current pattern of blood order and consumption at three teaching hospitals in Kerman city. 

 Materials and Methods

 In a cross-analytical study, blood order forms for 3182 patients were collected from three hospitals from May to July 2010. C/T ratio and TI were analyzed with descriptive statistics and frequency table tests.

 Results

 The overall ratios of C/T (Crossmatch/Transfusion) and TI (Transfusion Index) were 1.33 and 1.81, respectively. The results are considered to be desirable as compared with the standard figures of C/T≤ 2.5 and TI ≥ 0.5. Out of 7731 blood orders, the highest number pertained to heart surgery wards with 1704 (22%), and the least to ophthamology ward with 7 (0.09%).

 Conclusions

  Our results show that blood order and consumption in three teaching hospitals in Kerman city during 3 months were desirable. Although in comparison with other studies in Iran inconsistencies in blood order and consumption were seen. In conclusion, it is essential to prepare blood order and consumption protocols according to our regional conditions to improve the blood transfusion status .

  Abstract

 Background and Objectives

 Every single donated blood unit is a valuable capital. The aim of this study is to evaluate the rate of blood consumption in Kerman hospitals and suggest solutions to reduce the blood wastage.

 Materials and Methods

 This 4-year study evaluates the blood usage and wastage in three selected Kerman hospitals one affiliated to a university hospital, the other to the Social Security Organization, and the last to the private sector.

 Results

 The average usage of pack RBCs is higher than other products in the three hospitals: the university hospital 4190.25 ± 765.66 units per year, the Social Security Organization affiliated hospital 1660.75 ± 162.31 units per year, and the private hospital 231.8 ± 62.9 units per year. Annually, in the university hospital the average request of blood per active bed is 15.09 units/bed and the average usage is 14.8 units/bed cross matched to transfused blood (C/T) rate is not detectable due to inappropriate cross match registry in the university hospital. In the Social Security Organization affiliated hospital, the average blood request is 6.1 units/bed and the average blood usage is 4.9 units/bed the C/T ratio is 1.6. In the private hospital, the average blood request is 5.2 units/bed and the average blood usage is 4.4 units/bed the C/T ratio is 2.9.

 Conclusions

 The evidence shows that the blood usage in Kerman hospitals is approximately similar to the global standards. Since the preparation of a blood unit costs a lot of financial and intellectual charges, improving blood usage based on international standards is necessary.