oxford’s war on - transfusionguidelines.org · breech (but was
Post on 30-Aug-2018
224 Views
Preview:
TRANSCRIPT
Rrr
1
2
3
4
5
1. Started monitoring wastage
2. SCBU Paedi pack reduction (3
units)
3. FFP 5 day change
4. SCBU Paedi pack reduction (1 unit)
5. Stock level reduction
6. TP daily monitoring and
reporting (clinical wastage)
6
• Main stock at JR hospital
• Horton Hospital
• “Hot-lab” at Churchill hospital
• 6 Remote issue fridges
• 4 Remote storage fridges
Stock Holding Areas
• Greater monitoring increased awareness
• Stricter adherence to SOP for stock rotation
• Supernumerary MLA dedicated to stock control
Small Beginnings
• February 2016 paed pack issues 3 units/baby
• June 2016 paed pack issues 1 unit/baby with 1 day reservation
• Wastage reduced by 27%
• No increase in donor exposure
Paediatric units
• 1 adult dose (4 units) pre-thawed FFP
• April 2016 post-thaw storage increased to 120hrs
• Wastage reduced by 22%
Fresh Frozen Plasma
• July 2016 review of usage from remote issue fridges
• Stock levels reduced by approximately 20%
• No significant increase in re-stocking incidents out-of-hours
• Wastage reduced by 3%
• July 2017 further reduction
Stock Levels
• Coffee club to raise awareness
• List of short-dated units kept on work bench
• Rotating stock between JR and Churchill
• Order appropriate volumes for red cell exchanges
Other Actions
Wastage: Disaster TrailPre-op Hb (elective surgery) 101 g/l
Lowest intra op Hb 78 g/l
2 units remote issued
Anaesthetist change over (2nd
anaesthetist does not want to transfuse)
Unused units sent to recovery
Recovery not happy to Tx due to 30 minute breech (but was <4 hrs)
2 more units transfused
Post-op (post Tx) Hb 94 g/l
NICE QS1: iron
supplementation NICE QS 3:
Reassess after
RBC transfusions
NICE Hb
threshold: 70 g/l
(target 70-90)
top related