[Assessment of knowledge in blood transfusion of medical staff in 14 state-run hospitals]. / Evaluation des connaissances médicales transfusionnelles dans 14 établissements publics de santé

UNLABELLED: This multi-centre study aimed to assess the knowledge in blood transfusion of medical staff in 14 state-run hospitals. MATERIALS AND METHODS: A questionnaire was distributed to all potential prescribers of blood products. It contained 35 questions concerning various subjects: blood products, immuno-haematology, prescription of blood products, transfusion practice, interpretation of the final bedside controls. The rate of correct answers (RCA) was obtained for each question, for each subject, and for nine questions defined as essential for patient safety. A weighted score was also calculated by ranking each question between one and six according to its importance. RESULTS: Six hundred and ninety four questionnaires were analysed (rate of return 15%). The RCA ranged from 14 to 89%, according to the questions. The RCA ranged from 47 to 78% for seven of the nine essential safety questions, and 82% and 83% for the two questions concerning the interpretation of incompatible final bedside controls: there were 9% of wrong answers, which validated an incompatible blood transfusion. The mean weighted score was 62%. Both the RCA and the weighted score were higher for those that regularly prescribe blood products than for that only prescribe them occasionally. There were no significant differences between hospitals. CONCLUSION: This study has confirmed that medical staff have deficiencies in their knowledge of blood transfusion, deficiencies which are acknowledged by medical staff. These first results will help the members of the study group to develop and prioritize various actions to improve this state of affairs, and to follow the effects of the training given.

[Blood monitoring at the dawn of the 21st century]. / L'hémovigilance à l'aube du XXIe siècle.

A NEW DISCIPLINE: On January 4, 1993, the French parliament voted a law on Blood Transfusion Safety, creating a monitoring and warning system operating through a complex network and aimed at guaranteeing permanent efficacy, safety and efficiency of blood transfusion in France. A new discipline, blood monitoring was born. FUNDAMENTAL PRINCIPLES: Basically, blood monitoring is organized around two fundamental principles: blood products trackability from the donor to the recipient and mandatory reporting of all transfusion incidents. After a laborious development phase, the early results point out the immunological risk, particularly by ABO error, and the risk of bacterial contamination. AN EARLY WARNING SYSTEM: This blood monitoring system, whose primary purpose is to serve as an early warning device, must have the necessary tools to monitor, verify and analyze all available epidemiological data. Coordination of the blood monitoring system within the framework of the AFSSaPS (the French Agency for Sanitary Safety of Health Products) should enable it to fully reach this goal.