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6 Reasons Your Organization Should Practice Patient Blood Management

By a Verblio Writer

(928 words)

One out of every 10 people entering a hospital needs a blood transfusion. While the blood supply is safer than ever, the CDC lists numerous complications including allergic reactions, acute and delayed hemolytic transfusion reaction, hypotensive transfusion reaction, transfusion-associated circulatory overload (TACO), transfusion-transmitted infection (TTI), and numerous other complications that are completely foreign to patients. Simple statistics reveal that reducing the number of transfusions will reduce the risks and number of complications.

For this and other reasons, numerous medical facilities throughout the world have made patient blood management (PBM) part of their standard of care.

“Implementing a comprehensive patient blood management program helps institutions provide a higher quality of care to patients by avoiding blood loss; minimizing unnecessary blood transfusions; and conserving blood for patients who actually benefit from transfusions,” said AABB President Zbigniew Szczepiorkowski.

If your organization hasn’t made PBM a priority, here are six reasons you should.

1. Reduce the risk of infection. 

As noted, the U.S. blood supply is safer than ever, and blood screening techniques continue to improve. However, as recent as January of this year Medscape published a study that looked closely at infection risks.

Researchers noted, “A myriad of agents can potentially be transmitted through blood transfusions, including bacteria, viruses, and parasites.”

2. Eliminate the risk of reaction. 

The CDC clearly outlines the potential reactions to a blood transfusion. Using therapies that avoid a transfusion all together eliminates this risk.

“A blood transfusion is like giving a mini tissue transplant,” said Warren Behr, coordinator of blood management at Bronson Methodist Hospital in Kalamazoo, Mich. “You’re taking part of someone’s body and putting it in another person’s body. That results in immune-system suppression, and that sets a patient back.”

After major surgery, the last thing a patient needs is immune suppression. The fewer outside variables involved, the lower the risk of an adverse reaction after surgery.

3. Reserve blood for patients who need it. 

“The bottom line is blood is a unique resource,” said vascular surgeon Dr. John T. Collins. “When it is necessary, it is essential.”

Blood is a valuable resource that must be managed well. Using tools that reduce the number of unnecessary transfusions reserves blood for patients that really need it.

Additionally, research supports the case for not using blood older than 35 days. However, current standards allow blood to be stored 42 days. Older blood is often sent to facilities that use it frequently, such as trauma centers and academic medical centers. Reducing the demand for blood will allow newer, more effective blood to go to these patients.

In addition, blood processing and storage costs range from $700 to $1,000. Avoiding transfusions saves money for the facility, insurer, and patient.

4. Get better patient outcomes. 

“Even when these drastic outcomes are avoided, there’s something else about donated blood—which scientists don’t fully understand—that could slow recovery time or increase complications,” stated Dr. Paul Maggio from Stanford Medicine.

Blood transfusions have actually been linked to slower recovery times. JAMA Internal Medicine reported on a comprehensive study that tracked heart surgery patients over a 26-year period at the Cleveland Clinic. The research centered around Jehovah’s Witness patients, who refuse blood transfusions on religious grounds. The study revealed Jehovah’s Witness patients recovered better than patients that received transfusions. They had higher five-year survival rates, fewer heart attacks and other complications, including sepsis and renal failure.

5. Successfully meet compliance legislation. 

Healthcare reform has led to greater quality controls throughout the medical industry. From individual physician practices to large hospitals, quality measures directly impact reimbursements and funding. Quality indicators revolve around patient care, including readmission rates.

Avoiding a blood transfusion leads to better patient outcomes and less risk of reactions. In turn, the chance that a patient will return to the hospital is greatly reduced.

6. Become a patient advocate. 

Patient-centered care is at the core of quality care. Caring for patients is no longer about just solving their medical needs. Patient care involves respecting their beliefs and preferences. Whether patients want to avoid a blood transfusion for religious or health reasons, a physician should do all in his or her power to respect their wishes.

HealthAffairs says patient-centered care “replaces our current physician center system with one that revolves around the patient. Care is defined by or in consultation with patients rather than by physician dependent tools or standards.” Patients want an empathetic, understanding doctor with whom they feel like they have a personal relationship. A medical facility that places high importance on a patient-centered model will have greater patient satisfaction.

How can you get started? PBM involves a toolbox of pharmaceuticals, medical devices, and policy changes. For example, Dr. Tim Goodnough, a hematologist at Stanford, explained that when a physician orders a blood transfusion in their hospital for a patient with a hemoglobin level at about eight, a pop-up appears on the computer. The system is designed to make physicians think twice.

Another hospital launched a marketing campaign among staff called “why give two when one will do?” The purpose was to get physicians to think twice about ordering two units of blood. Other options involve promoting the use of cell salvage machines and hemodilution. These tools ensure that blood lost to the physician is not lost to the surgeon. Additionally, physicians carefully monitor patients before surgery to ensure they do not go in already anemic. Iron supplements or erythropoietin (EPO) can be given ahead of surgery to build the patient’s red blood cell count.

Hospitals around the globe are reaping the rewards of patient blood management. Become a patient advocate by offering alternative treatments for your patients.


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