How we treat: transfusion medicine support of obstetric services
BACKGROUND: Obstetric services depend on the transfusion service (TS) to provide diagnostic testing and blood component therapy for clinical care pathways. STUDY DESIGN AND METHODS: We describe three quality improvement (QI) initiatives implemented to improve TS support of obstetric services. RESULT...
Gespeichert in:
| Veröffentlicht in: | Transfusion (Philadelphia, Pa.) Pa.), 2011-12, Vol.51 (12), p.2540-2548 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 2548 |
|---|---|
| container_issue | 12 |
| container_start_page | 2540 |
| container_title | Transfusion (Philadelphia, Pa.) |
| container_volume | 51 |
| creator | Goodnough, Lawrence T. Daniels, Kay Wong, Amy E. Viele, Maurene Fontaine, Magali F. Butwick, Alexander J. |
| description | BACKGROUND: Obstetric services depend on the transfusion service (TS) to provide diagnostic testing and blood component therapy for clinical care pathways.
STUDY DESIGN AND METHODS: We describe three quality improvement (QI) initiatives implemented to improve TS support of obstetric services.
RESULTS: We implemented a pathway for patients requiring an ABO/Rh order for every admission to obstetric services, along with reconciliation of the daily hospital birth manifest and TS umbilical cord log to identify every woman eligible for RhIG. After assessment over 6 months, 21 (1%) of 2041 women lacked an admission ABO/Rh; all subsequently had ABO/Rh determinations. Umbilical cords were missing for eight (0.4%) mothers; four were D− and received RhIG. We developed algorithms for diagnostic blood ordering for patients deemed at “low,”“moderate,” or “high” risk of blood transfusion. A 27% reduction in total diagnostic test volumes and 24% reduction in charges was documented after compared to before implementation. We analyzed the impact of our massive transfusion protocol (MTP) on blood inventory management for 31 (0.25%) women undergoing 12,945 deliveries, representing 11% of 286 MTPs for all clinical services over a 32‐month interval. O− uncrossmatched red blood cells (RBCs) represented 103 (24%) of 421 RBC units issued. Wastage rates of RBCs, plasma, and platelets ordered and issued in the MTPs were 0.7, 16, and 3%, respectively.
CONCLUSION: QI initiatives for RhIG prophylaxis, diagnostic blood test ordering, and MTP improve TS support of obstetric services. |
| doi_str_mv | 10.1111/j.1537-2995.2011.03152.x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_911943148</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>911943148</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5022-14c9ee23a042b4edbea9fad0d8d71cce4b809c6841f61d26c5a4717aa2b91ec53</originalsourceid><addsrcrecordid>eNqNkF1r2zAUhsVoabOuf2H4ZvTKno4-YmswaFeapBBaGCm9FLJ8DMqcOJXsJf33lZcsva1ujkDPe47OQ0gCNIN4vi8zkDxPmVIyYxQgoxwky3afyOj4cEJGlApIATg7J59DWFJKmaJwRs4ZSMEKSUfketZuky0mnUfT_YjFrEPdB9eukxVWzro1JqHfbFrfJW2dtGXosPPOJgH9X2cxfCGntWkCXh7qBXma3C1uZ-n8cXp_ezNPraSMpSCsQmTcUMFKgVWJRtWmolVR5WAtirKgyo4LAfUYKja20ogccmNYqQCt5Bfkat9349uXHkOnVy5YbBqzxrYPWgEowUEUkSz2pPVtCB5rvfFuZfyrBqoHfXqpB0t6sKQHffqfPr2L0a-HIX0Z1z8G__uKwLcDYII1TR11WRfeOck5sIJH7uee27oGXz_8Ab34PRluMZ_u8y763h3zxv_R45znUj8_TLWczybFLP-lgb8BDRGaMg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>911943148</pqid></control><display><type>article</type><title>How we treat: transfusion medicine support of obstetric services</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Goodnough, Lawrence T. ; Daniels, Kay ; Wong, Amy E. ; Viele, Maurene ; Fontaine, Magali F. ; Butwick, Alexander J.</creator><creatorcontrib>Goodnough, Lawrence T. ; Daniels, Kay ; Wong, Amy E. ; Viele, Maurene ; Fontaine, Magali F. ; Butwick, Alexander J.</creatorcontrib><description>BACKGROUND: Obstetric services depend on the transfusion service (TS) to provide diagnostic testing and blood component therapy for clinical care pathways.
STUDY DESIGN AND METHODS: We describe three quality improvement (QI) initiatives implemented to improve TS support of obstetric services.
RESULTS: We implemented a pathway for patients requiring an ABO/Rh order for every admission to obstetric services, along with reconciliation of the daily hospital birth manifest and TS umbilical cord log to identify every woman eligible for RhIG. After assessment over 6 months, 21 (1%) of 2041 women lacked an admission ABO/Rh; all subsequently had ABO/Rh determinations. Umbilical cords were missing for eight (0.4%) mothers; four were D− and received RhIG. We developed algorithms for diagnostic blood ordering for patients deemed at “low,”“moderate,” or “high” risk of blood transfusion. A 27% reduction in total diagnostic test volumes and 24% reduction in charges was documented after compared to before implementation. We analyzed the impact of our massive transfusion protocol (MTP) on blood inventory management for 31 (0.25%) women undergoing 12,945 deliveries, representing 11% of 286 MTPs for all clinical services over a 32‐month interval. O− uncrossmatched red blood cells (RBCs) represented 103 (24%) of 421 RBC units issued. Wastage rates of RBCs, plasma, and platelets ordered and issued in the MTPs were 0.7, 16, and 3%, respectively.
CONCLUSION: QI initiatives for RhIG prophylaxis, diagnostic blood test ordering, and MTP improve TS support of obstetric services.</description><identifier>ISSN: 0041-1132</identifier><identifier>EISSN: 1537-2995</identifier><identifier>DOI: 10.1111/j.1537-2995.2011.03152.x</identifier><identifier>PMID: 21542850</identifier><identifier>CODEN: TRANAT</identifier><language>eng</language><publisher>Malden, USA: Blackwell Publishing Inc</publisher><subject>ABO Blood-Group System ; Algorithms ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Blood Component Transfusion - methods ; Blood Component Transfusion - standards ; Blood Grouping and Crossmatching - methods ; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis ; Delivery, Obstetric ; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care ; Female ; Humans ; Intensive care medicine ; Medical sciences ; Obstetrics - methods ; Quality Assurance, Health Care ; Rh Isoimmunization - diagnosis ; Rh Isoimmunization - drug therapy ; Rh-Hr Blood-Group System ; Rho(D) Immune Globulin - therapeutic use ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy</subject><ispartof>Transfusion (Philadelphia, Pa.), 2011-12, Vol.51 (12), p.2540-2548</ispartof><rights>2011 American Association of Blood Banks</rights><rights>2015 INIST-CNRS</rights><rights>2011 American Association of Blood Banks.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5022-14c9ee23a042b4edbea9fad0d8d71cce4b809c6841f61d26c5a4717aa2b91ec53</citedby><cites>FETCH-LOGICAL-c5022-14c9ee23a042b4edbea9fad0d8d71cce4b809c6841f61d26c5a4717aa2b91ec53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1537-2995.2011.03152.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1537-2995.2011.03152.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25331283$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21542850$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Goodnough, Lawrence T.</creatorcontrib><creatorcontrib>Daniels, Kay</creatorcontrib><creatorcontrib>Wong, Amy E.</creatorcontrib><creatorcontrib>Viele, Maurene</creatorcontrib><creatorcontrib>Fontaine, Magali F.</creatorcontrib><creatorcontrib>Butwick, Alexander J.</creatorcontrib><title>How we treat: transfusion medicine support of obstetric services</title><title>Transfusion (Philadelphia, Pa.)</title><addtitle>Transfusion</addtitle><description>BACKGROUND: Obstetric services depend on the transfusion service (TS) to provide diagnostic testing and blood component therapy for clinical care pathways.
STUDY DESIGN AND METHODS: We describe three quality improvement (QI) initiatives implemented to improve TS support of obstetric services.
RESULTS: We implemented a pathway for patients requiring an ABO/Rh order for every admission to obstetric services, along with reconciliation of the daily hospital birth manifest and TS umbilical cord log to identify every woman eligible for RhIG. After assessment over 6 months, 21 (1%) of 2041 women lacked an admission ABO/Rh; all subsequently had ABO/Rh determinations. Umbilical cords were missing for eight (0.4%) mothers; four were D− and received RhIG. We developed algorithms for diagnostic blood ordering for patients deemed at “low,”“moderate,” or “high” risk of blood transfusion. A 27% reduction in total diagnostic test volumes and 24% reduction in charges was documented after compared to before implementation. We analyzed the impact of our massive transfusion protocol (MTP) on blood inventory management for 31 (0.25%) women undergoing 12,945 deliveries, representing 11% of 286 MTPs for all clinical services over a 32‐month interval. O− uncrossmatched red blood cells (RBCs) represented 103 (24%) of 421 RBC units issued. Wastage rates of RBCs, plasma, and platelets ordered and issued in the MTPs were 0.7, 16, and 3%, respectively.
CONCLUSION: QI initiatives for RhIG prophylaxis, diagnostic blood test ordering, and MTP improve TS support of obstetric services.</description><subject>ABO Blood-Group System</subject><subject>Algorithms</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Blood Component Transfusion - methods</subject><subject>Blood Component Transfusion - standards</subject><subject>Blood Grouping and Crossmatching - methods</subject><subject>Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis</subject><subject>Delivery, Obstetric</subject><subject>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</subject><subject>Female</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Medical sciences</subject><subject>Obstetrics - methods</subject><subject>Quality Assurance, Health Care</subject><subject>Rh Isoimmunization - diagnosis</subject><subject>Rh Isoimmunization - drug therapy</subject><subject>Rh-Hr Blood-Group System</subject><subject>Rho(D) Immune Globulin - therapeutic use</subject><subject>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</subject><issn>0041-1132</issn><issn>1537-2995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkF1r2zAUhsVoabOuf2H4ZvTKno4-YmswaFeapBBaGCm9FLJ8DMqcOJXsJf33lZcsva1ujkDPe47OQ0gCNIN4vi8zkDxPmVIyYxQgoxwky3afyOj4cEJGlApIATg7J59DWFJKmaJwRs4ZSMEKSUfketZuky0mnUfT_YjFrEPdB9eukxVWzro1JqHfbFrfJW2dtGXosPPOJgH9X2cxfCGntWkCXh7qBXma3C1uZ-n8cXp_ezNPraSMpSCsQmTcUMFKgVWJRtWmolVR5WAtirKgyo4LAfUYKja20ogccmNYqQCt5Bfkat9349uXHkOnVy5YbBqzxrYPWgEowUEUkSz2pPVtCB5rvfFuZfyrBqoHfXqpB0t6sKQHffqfPr2L0a-HIX0Z1z8G__uKwLcDYII1TR11WRfeOck5sIJH7uee27oGXz_8Ab34PRluMZ_u8y763h3zxv_R45znUj8_TLWczybFLP-lgb8BDRGaMg</recordid><startdate>201112</startdate><enddate>201112</enddate><creator>Goodnough, Lawrence T.</creator><creator>Daniels, Kay</creator><creator>Wong, Amy E.</creator><creator>Viele, Maurene</creator><creator>Fontaine, Magali F.</creator><creator>Butwick, Alexander J.</creator><general>Blackwell Publishing Inc</general><general>Wiley</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201112</creationdate><title>How we treat: transfusion medicine support of obstetric services</title><author>Goodnough, Lawrence T. ; Daniels, Kay ; Wong, Amy E. ; Viele, Maurene ; Fontaine, Magali F. ; Butwick, Alexander J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5022-14c9ee23a042b4edbea9fad0d8d71cce4b809c6841f61d26c5a4717aa2b91ec53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>ABO Blood-Group System</topic><topic>Algorithms</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Blood Component Transfusion - methods</topic><topic>Blood Component Transfusion - standards</topic><topic>Blood Grouping and Crossmatching - methods</topic><topic>Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis</topic><topic>Delivery, Obstetric</topic><topic>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</topic><topic>Female</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Medical sciences</topic><topic>Obstetrics - methods</topic><topic>Quality Assurance, Health Care</topic><topic>Rh Isoimmunization - diagnosis</topic><topic>Rh Isoimmunization - drug therapy</topic><topic>Rh-Hr Blood-Group System</topic><topic>Rho(D) Immune Globulin - therapeutic use</topic><topic>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Goodnough, Lawrence T.</creatorcontrib><creatorcontrib>Daniels, Kay</creatorcontrib><creatorcontrib>Wong, Amy E.</creatorcontrib><creatorcontrib>Viele, Maurene</creatorcontrib><creatorcontrib>Fontaine, Magali F.</creatorcontrib><creatorcontrib>Butwick, Alexander J.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Transfusion (Philadelphia, Pa.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Goodnough, Lawrence T.</au><au>Daniels, Kay</au><au>Wong, Amy E.</au><au>Viele, Maurene</au><au>Fontaine, Magali F.</au><au>Butwick, Alexander J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>How we treat: transfusion medicine support of obstetric services</atitle><jtitle>Transfusion (Philadelphia, Pa.)</jtitle><addtitle>Transfusion</addtitle><date>2011-12</date><risdate>2011</risdate><volume>51</volume><issue>12</issue><spage>2540</spage><epage>2548</epage><pages>2540-2548</pages><issn>0041-1132</issn><eissn>1537-2995</eissn><coden>TRANAT</coden><abstract>BACKGROUND: Obstetric services depend on the transfusion service (TS) to provide diagnostic testing and blood component therapy for clinical care pathways.
STUDY DESIGN AND METHODS: We describe three quality improvement (QI) initiatives implemented to improve TS support of obstetric services.
RESULTS: We implemented a pathway for patients requiring an ABO/Rh order for every admission to obstetric services, along with reconciliation of the daily hospital birth manifest and TS umbilical cord log to identify every woman eligible for RhIG. After assessment over 6 months, 21 (1%) of 2041 women lacked an admission ABO/Rh; all subsequently had ABO/Rh determinations. Umbilical cords were missing for eight (0.4%) mothers; four were D− and received RhIG. We developed algorithms for diagnostic blood ordering for patients deemed at “low,”“moderate,” or “high” risk of blood transfusion. A 27% reduction in total diagnostic test volumes and 24% reduction in charges was documented after compared to before implementation. We analyzed the impact of our massive transfusion protocol (MTP) on blood inventory management for 31 (0.25%) women undergoing 12,945 deliveries, representing 11% of 286 MTPs for all clinical services over a 32‐month interval. O− uncrossmatched red blood cells (RBCs) represented 103 (24%) of 421 RBC units issued. Wastage rates of RBCs, plasma, and platelets ordered and issued in the MTPs were 0.7, 16, and 3%, respectively.
CONCLUSION: QI initiatives for RhIG prophylaxis, diagnostic blood test ordering, and MTP improve TS support of obstetric services.</abstract><cop>Malden, USA</cop><pub>Blackwell Publishing Inc</pub><pmid>21542850</pmid><doi>10.1111/j.1537-2995.2011.03152.x</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0041-1132 |
| ispartof | Transfusion (Philadelphia, Pa.), 2011-12, Vol.51 (12), p.2540-2548 |
| issn | 0041-1132 1537-2995 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_911943148 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | ABO Blood-Group System Algorithms Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Blood Component Transfusion - methods Blood Component Transfusion - standards Blood Grouping and Crossmatching - methods Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis Delivery, Obstetric Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care Female Humans Intensive care medicine Medical sciences Obstetrics - methods Quality Assurance, Health Care Rh Isoimmunization - diagnosis Rh Isoimmunization - drug therapy Rh-Hr Blood-Group System Rho(D) Immune Globulin - therapeutic use Transfusions. Complications. Transfusion reactions. Cell and gene therapy |
| title | How we treat: transfusion medicine support of obstetric services |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-03T05%3A10%3A41IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=How%20we%20treat:%20transfusion%20medicine%20support%20of%20obstetric%20services&rft.jtitle=Transfusion%20(Philadelphia,%20Pa.)&rft.au=Goodnough,%20Lawrence%20T.&rft.date=2011-12&rft.volume=51&rft.issue=12&rft.spage=2540&rft.epage=2548&rft.pages=2540-2548&rft.issn=0041-1132&rft.eissn=1537-2995&rft.coden=TRANAT&rft_id=info:doi/10.1111/j.1537-2995.2011.03152.x&rft_dat=%3Cproquest_cross%3E911943148%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=911943148&rft_id=info:pmid/21542850&rfr_iscdi=true |