Document Detail


The appropriateness and physician compliance of platelet usage by a computerized transfusion decision support system in a medical center.
MedLine Citation:
PMID:  20576016     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The prescribing of inappropriate platelet (PLT) transfusions is always a significant problem. A computerized transfusion decision support system (CTDSS) has been used in Kaohsiung Medical University Hospital since September 2004. In this study, the physician compliance and appropriateness of PLT usage after using the CTDSS were investigated.
STUDY DESIGN AND METHODS: A total of 5887 PLT transfusion episodes between January and December 2008 were reviewed including the demographic data and the "true reason" for each transfusion practice. The pre- and posttransfusion PLT counts were retrieved. The physician compliance, the appropriateness of PLT usage, and the PLT increments after transfusion were investigated.
RESULTS: Physician compliance was 85.4%, and the appropriateness of PLT usage was 69.6%. The most commonly chosen indication from the CTDSS was "prophylactic use, PLT count ≤20×10(9) /L." The highest inappropriate order rate was from the emergency department. More than half of the inappropriate episodes were from the surgery unit. The inappropriate rates were significant in terms of both different order sources and functional units (p<0.0001). The posttransfusion PLT counts increased in two-thirds of the episodes, and most of them were with the pretransfusion PLT counts of less than 50×10(9) /L.
CONCLUSIONS: In Taiwan, the PLT concentration is too low-priced and this might cause the overuse of blood components. Under the global budget of National Health Insurance, preventing the overuse of blood components might serve as one of the mechanism to improve medical quality. The CTDSS should be more powerful and effective to intervene in the appropriateness of transfusion practice.
Authors:
Yi-Ching Lin; Chao-Sung Chang; Chi-Jung Yeh; Yung-Chao Wu
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Transfusion     Volume:  50     ISSN:  1537-2995     ISO Abbreviation:  Transfusion     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-03     Completed Date:  2011-01-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2565-70     Citation Subset:  IM    
Copyright Information:
© 2010 American Association of Blood Banks.
Affiliation:
Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Academic Medical Centers
Algorithms
Clinical Competence / statistics & numerical data
Computer Simulation / utilization
Decision Support Techniques*
Female
Guideline Adherence* / statistics & numerical data
Humans
Male
Physicians* / standards,  statistics & numerical data
Platelet Transfusion / utilization*
Program Evaluation
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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