Strategies for the review of transfusion practices
L. E. Silberstein, M. S. Kruskall, L. C. Stehling, M. F. Johnston, R. C. Rutman, C. T. Samia, G. Ramsey and R. S. Eisenstaedt
Hospital of the University of Pennsylvania, Philadelphia 19104-4283.
The intent of this report is to familiarize health care professionals with
the concept of effective quality assurance in regard to blood use. Although
evaluation of the appropriateness of transfusion therapy is now required by
the Joint Commission on Accreditation of Health Organizations, health care
facilities have little experience with this aspect of professional quality
assurance. To this end, the Committee on Transfusion Practices of the
American Association of Blood Banks, in Arlington, Va, in this report has
provided examples of indications and audit criteria for individual blood
components and products and commented on areas of controversy surrounding
their use. Audit criteria from different institutions may vary because of
differences in local interpretation of the indication, different patient
populations, and, in some instances, the availability of blood and
laboratory services. Several approaches to the review of transfusion
practices are discussed in relation to clinical settings and pertaining to
particular blood components. It is evident from these examples that there
will be an increased need for trained personnel to perform the initial
review process as well as for physicians trained in transfusion medicine to
oversee the transfusions and provide the necessary consultation.
