Bringing Transfusion Practice into the 21st Century
Last year, America's Blood Centers created the Transfusion Safety Committee as a subcommittee of ABC's Scientific, Medical, and Technical (SMT) Committee. Our charge is to organize and promote the integration of ABC centers with their customers through transfusion safety officer (TSO) services, including patient education, clinical staff education, and patient blood management. We developed a transfusion safety project list via a survey of the ABC Transfusion Safety Forum members.
Recently, researchers administered an assessment tool consisting of a 23-question survey and a 20-question examination to 474 internal medicine residents in nine countries at 23 programs to determine prior training, attitudes, perceived ability, and actual knowledge related to transfusion medicine. The overall mean score of correct responses was 45.7 percent (site range, 32-56 percent). The authors concluded that internationally, internal medicine residents have poor transfusion medicine knowledge and would welcome additional training. (Haspel RL, et al. Transfusion 2015; 55:1355-61).
A Joint Commission and American Medical Association report published in September 2012 recognized "gaps in medical school and continuing professional education" and noted that "there are very short exposures to transfusion medicine in crowded medical school and residency curricula, and most ordering physicians do not receive additional education on transfusion medicine. Mindful of this, it is not surprising that addressing the lack of knowledge of the current evidenced-based transfusion thresholds was made the No. 1 priority on the committee's project list.
We sought to develop up-to-date resources for current indications and transfusion thresholds for blood products to be used by practicing clinicians. These will provide value to ABC member centers who share the materials with their hospitals. Three working group teams - one each for red blood cells, platelets, and plasma - assembled source materials for their assigned product.
They developed short PowerPoint presentations (no more than 10 slides) and one-page job aids regarding transfusion indications and thresholds for each blood product. Each resource allows the blood center to add its branding. The job aids can be reduced to a pocket-sized guide to be placed in a lab coat pocket.
The next step is to spread the word to the ABC members. A webinar on Sept. 21 at 3 p.m. ET will provide additional details of this project and all materials will be placed on the ABC member site. The goal was to produce deliverables that are succinct and easy to read, yet provide the evidenced-based thresholds necessary to move clinicians' transfusion medicine practices into the 21st century.
Richard Gammon, MD; Co-Chair, ABC Transfusion Safety Transfusion Trigger Working Group; Richard.Gammon@oneblood.org
Jed Gorlin, MD; Co-Chair, ABC Transfusion Safety, Transfusion Trigger Working Group; Jed.GorlinMD@innovativeblood.org