Prospective audit of cytomegalovirus-negative blood product utilization inhaematology/oncology patients

The transfusion management of immunocompromised patients often requires spe cial blood product use such as cytomegalovirus (CMV)-negative cellular prod ucts, which are more costly than standard blood products and occasionally i n short supply. We audited the use of CMV-negative products in haematology/ oncology patients to determine the appropriateness of their use. A concurre nt-prospective audit was conducted of all orders for CMV-negative packed re d blood cell (PRBC) and platelet products in 201 haematology/oncology patie nts. Once CMV serostatus was determined, orders for inappropriate CMV-negat ive units were cancelled, and filled as CMV untested units. During the 21-m onth period of this audit, the rates of inappropriate transfusions decrease d for PRBC from 73.2% to 14.3% (chi(2) = 68.4, P < 0.001) and for platelets from 68.1% to 10.6% (chi(2) = 65.6, P < 0.001). The median time to cancell ation of inappropriate CMV-negative orders was 11 days. This audit resulted in estimated cost savings of $16 500 over the 21-month duration. Inappropr iate requests for scarce and expensive blood products are substantially red uced by concurrent-prospective auditing of transfusion practice, in a manne r that is both simple and cost effective.