Abstract: Although blood ordering is a common practice in surgical field, the average requirement for a particular procedure is usually based on subjective anticipation of blood loss rather than on evidence based estimates. Over-ordering with minimal utilization squanders technical time, reagent and imposes extra expenses on patients. The purpose of this study was to determine the efficiency of blood utilization for elective and emergency surgery at Ndola Central Hospital with a view of establishing a Maximum Surgical Blood Order Schedule (MSBOS).
Methods: Laboratory-based retrospective descriptive study was conducted at Ndola Central hospital. Data for elective and emergency surgeries were collected from all discharged surgical patients and blood bank registries. Blood utilization was calculated using crossmatch to transfusion ratio (C/T), transfusion probability (%T), and transfusion index (TI) indices.
Results: During the study period, the transfusion department was requested to prepare 2,300 units of blood for 2,100 patients. Of these, 810 units were transfused for 400 patients. Blood transfusion from the units crossmatched was 35.2%. The overall ratios of C/T, %T, and TI index were 2.8, 20.0%, and 0.40, respectively. These blood utilization indices showed a different value between each department. In department of surgery, for instance, overall C/T ratio was 2.8 with high ratio in elective than emergency (4.1 versus 1.9). In addition, the overall %T was 14.5% with 20.9% in emergency and 9.7% in elective patients. On the other hand, in department of gynecology and obstetrics, the overall C/T ratio was 2.8 with elective surgical patients having the highest C/T ratio (4.3) than emergency patients (1.6). Moreover, the overall %T and TI were 26.1% and 0.38, respectively.
Conclusions: The overall blood utilization was not encouraging and excessive crossmatching with minimal transfusion practice was observed in elective surgical patients. However, for emergency surgical procedures blood utilization was within the acceptable limits. Therefore, blood ordering pattern for elective procedures need to be revised and over-ordering of blood should be minimized. Moreover, the hospital with blood transfusion committee should formulate maximum surgical blood ordering policies for elective surgical procedures and conduct regular auditing.
Keywords: Blood Requisition, elective surgery, MSBOS, Transfusion Index, cossmatch.
Title: Analysis of Blood Cross-match ordering practice in surgical patients at Ndola Central Hospital
Author: Alick Mwambungu, Nathan Siulapwa, Duncan Mugala, Mwamba Chishimba
International Journal of Healthcare Sciences
ISSN 2348-5728 (Online)
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