IMPROVING TRANSFUSION PRACTICES IN A BUSY TEACHING HOSPITAL

A retrospective audit of blood transfusions was carried out in Cardiff Royal Infirmary (CRT) to investigate how efficiently blood was reques ted and used by the various clinical directorates. Excessive crossmatc h/transfusion (C/T) ratios were found for a number of operations. In a n attempt to improve practices, a pilot study was carried out between the Department of Haematology and the largest single requesting group, the Orthopaedic Directorate. As a result of a preliminary retrospecti ve audit, crossmatch guidelines were revised, with more reliance on th e group and antibody screen (G&S) for low-risk operations. A subsequen t prospective audit showed major reductions in crossmatch requests and a general decrease in C/T ratios to very efficient levels without any patient morbidity. Blood was freed for urgent use elsewhere, and sign ificant cost improvements resulted. This study, using the orthopaedic surgery department as a model, shows the value of inter-departmental a udit and supports the experience of other centres using similar method s to make considerable savings in the amount of blood crossmatched unn ecessarily.