Red cell & platelet transfusion in adult haematology patient 2016
- Collect information on the context in which care was delivered through the use of an organisational questionnaire
- Identify variation in practice and compare practice against guidelines
- Examine the use of red cells and platelets in a sample of patients who had a known haematological condition
Who did we audit?
- Adults (16 years or over), with a malignant haematological diagnosis or bone marrow failure who received red cells, or platelets, or both in January 2016
Who took part?
- Organisational audit: 151 hospitals
- Clinical audit:
- 170 sites
- 4649 patients
- 6109 transfusion episodes (4328 red cell transfusions and 1781 platelet transfusions).
What did we find?
For improving local guidelines
- Local hospital guidelines must be easily available and reflect national guidelines for blood transfusion.
- Local hospital guidelines should state that prophylactic platelet transfusions are not required:Local hospital guidelines should state how to manage transfusions in patients at high risk of Transfusion Associated Circulatory Overload (TACO)
- Prior to bone marrow aspirates and trephine
- In stable patients with chronic bone marrow failure
For local audit
- Information technology solutions are required to allow regular non-labour intensive audit of transfusion practice.
For improving clinical practice
- The reason for transfusion should be clearly documented in the patient’s record including any individual threshold agreed for that patient
- In the absence of active bleeding use the minimum number of red cell units required to achieve target haemoglobin and consider a single unit transfusion
- One adult therapeutic dose of platelets is required for prophylaxis. Pre-procedure consider the size of the patient, previous platelet count increments and the target platelet count.
- Risk assess the patient for transfusion-associated circulatory overload (TACO) which is the transfusion reaction most commonly associated with death
To help improve practice
Please cite as:
The Haematology Audit Working Group, on behalf of the National Comparative Audit in Blood Transfusion (NCABT) Steering Group. The 2016 audit of red cell & platelet transfusion in adult haematology patients (2017)