Concurrent Audit of Bedside Blood Transfusion Practices and Outcome of Education and Intervention at a Tertiary Care Hospital

Abstract

Aim and background: Blood transfusion is a multistep process involving many professionals from different areas.Proper bedside transfusion practice and guideline adherence are important for patient safety and timely identification of possible errors.Auditing the blood administration practice is necessary for the hospital transfusion service to improve the quality and excellence in patient care.Materials and methods: An audit on bedside transfusion practice was carried out within 12-24 hours of transfusion for 1 year.The time period was divided into two phases.In phase I, the key areas where guideline adherence was lacking were identified, and an educational plan was designed and implemented in the second phase.The outcome of the educational plan on bedside transfusion practice was evaluated in phase III.A total of 19,649 blood products (9,874 in phase I, 2,807 in phase II, and 6,968 in phase III) were issued from the blood center during the study period.The number of units included in phase I was 7,036 (n 1 = 7,036), and phase III included 5,052 (n 2 = 5,052), and the rest of the units were excluded from the audit for different reasons.Results: Good and safe transfusion practices were observed in the majority of the areas.In phase I, non-compliance was observed in consent taking (28.39%), monitoring vitals (17.59%), start and completion time record (11.19%), delay in initiation (16.79%),delay in completion (0.27%), and return of empty bag (19.20%).Wastage of blood (0.02%) was also noticed.A significant improvement was observed in most of the areas after the implementation of the educational plan in phase III.Conclusion: Regular audit of bedside transfusion practice and continuous education are necessary to improve and sustain guideline adherence.Clinical significance: Regular audit and continuous education are crucial to improve clinical transfusion practice and blood safety.