Quality Improvement Project of a Massive Transfusion Protocol (MTP) to Reduce Wastage of Blood Components
| Autor: | Maha Balouch, David J. Ciesla, Hesham A. Abowali, Enrico M. Camporesi, Jin Deng, Jason W Wilson, Garrett Enten, Aryeh Shander, Gerardo Bosco, Matteo Paganini |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Quality management MTP Health Toxicology and Mutagenesis lcsh:Medicine 030204 cardiovascular system & hematology Single level Article quality improvement blood component transfusion 03 medical and health sciences 0302 clinical medicine Clinical Protocols Trauma Centers Blood Component Transfusion Medicine Humans Blood Transfusion waste Protocol (science) business.industry Blood component Trauma center lcsh:R Public Health Environmental and Occupational Health 030208 emergency & critical care medicine Massive transfusion Emergency medicine Wounds and Injuries massive transfusion protocol business |
| Zdroj: | International Journal of Environmental Research and Public Health Volume 18 Issue 1 International Journal of Environmental Research and Public Health, Vol 18, Iss 274, p 274 (2021) |
| ISSN: | 1660-4601 |
| DOI: | 10.3390/ijerph18010274 |
| Popis: | Massive transfusion protocols (MTPs) facilitate the organized delivery of blood components for traumatically injured patients. MTPs vary across institutions, and ratios of blood components can change during clinical management. As a result, significant amounts of components can be wasted. We completed a review of all MTP activations from 2015 to 2018, providing an in-depth analysis of waste in our single Level 1 trauma center. An interdepartmental group analyzed patterns of blood component wastage to guide three quality improvement initiatives. Specifically, we (1) completed a digital timeline for each MTP activation and termination, (2) improved communications between departments, and (3) provided yearly training for all personnel about MTP deployment. The analysis identified an association between delayed MTP deactivations and waste (RR = 1.48, CI 1.19&ndash 1.85, p = 0.0005). An overall improvement in waste was seen over the years, but this could not be attributed to increased closed-loop communication as determined by the proportion of non-stop activations (F(124,3) = 0.98, not significant). Delayed MTP deactivations are the primary determinant of blood component waste. Our proactive intervention on communications between groups was not sufficient in reducing the number of delayed deactivations. However, implementing a digital timeline and regular repetitive training yielded a significant reduction in wasted blood components. |
| Databáze: | OpenAIRE |
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