Effectiveness of Provider Education Followed by Computerized Provider Order Entry Alerts in Reducing Inappropriate Red Blood Cell Transfusion
Open Access
- 5 December 2016
- journal article
- Published by Hindawi Limited in Journal of Blood Transfusion
- Vol. 2016, 1-6
- https://doi.org/10.1155/2016/2859720
Abstract
To reduce the rate of inappropriate red blood cell transfusion, a provider education program, followed by alerts in the computerized provider order entry system (CPOE), was established to encourage AABB transfusion guidelines. Metrics were established for nonemergent inpatient transfusions. Service lines with high order volume were targeted with formal education regarding AABB 2012 transfusion guidelines. Transfusion orders were reviewed in real time with email communications sent to ordering providers falling outside of AABB recommendations. After 12 months of provider education, alerts were activated in CPOE. With provider education alone, the incidence of pretransfusion hemoglobin levels greater than 8 g/dL decreased from 16.64% to 6.36%, posttransfusion hemoglobin levels greater than 10 g/dL from 14.03% to 3.78%, and number of nonemergent two-unit red blood cell orders from 45.26% to 22.66%. Red blood cell utilization decreased by 13%. No additional significant reduction in nonemergent two-unit orders was observed with CPOE alerts. Provider education, an effective and low-cost method, should be considered as a first-line method for reducing inappropriate red blood cell transfusion rates in stable adult inpatients. Alerts in the computerized order entry system did not significantly lower the percentage of two-unit red blood cells orders but may help to maintain educational efforts.Keywords
This publication has 19 references indexed in Scilit:
- Red Blood Cell Transfusion: A Clinical Practice Guideline From the AABB*Annals of Internal Medicine, 2012
- New frontiers in transfusion biology: identification and significance of mediators of morbidity and mortality in stored red blood cellsTransfusion, 2011
- Association between duration of storage of transfused red blood cells and morbidity and mortality in adult patients: myth or reality?Transfusion, 2009
- Clinical consequences of red cell storage in the critically illTransfusion, 2006
- Deleterious clinical effects of transfusion immunomodulation: proven beyond a reasonable doubtTransfusion, 2005
- Reducing the Amount of Blood TransfusedArchives of Internal Medicine, 2005
- Improvement in fresh frozen plasma transfusion practice: results of an outcome auditTransfusion Medicine, 2004
- A Multicenter, Randomized, Controlled Clinical Trial of Transfusion Requirements in Critical CareThe New England Journal of Medicine, 1999
- Hospital-Wide Educational Program Decreases Red Blood Cell TransfusionsJournal of Surgical Research, 1998
- The effect of provider education on blood utilization practicesAmerican Journal of Obstetrics and Gynecology, 1993