An analysis of the pattern of blood requisition and utilization in a tertiary care center.

ABSTRACT

Background: Blood utilization audit helps to formulate guidelines for improving transfusion practice in a health care centre. With increasing demand for blood components being unable to meet the supply particularly in developing countries, there is a need to implement strategies for rational use of blood and its components. The present study aims to evaluate the transfusion practices in a hospital based blood centre. Material and Methods: A retrospective audit was conducted on 1000 blood requisitions and 300 requisitions for fresh frozen plasma and platelets. The requisitions were reviewed for pre transfusion hematological values, utilization trends and appropriateness. Results: Out of 1000 requisitions, 67.8% were for packed red cells and 32.2% were for whole blood. Pre transfusion hemoglobin values were available for 11.1%. The urgency for transfusion and indication was mentioned on 18.1% of requisition forms. The maximum cross match to transfusion ratio was for Department of Obstetrics and Gynaecology. The blood utilization was 41.3%. Out of 300 requisitions for fresh frozen plasma/platelets, 67.33% were for fresh frozen plasma and 32.6% were for platelets. Only 25.66% of requisitions had prothrombin index/platelet count mentioned. Over ordering was seen in 37.33% of requisitions. Conclusion: Retrospective audits help to identify key areas that need interventions to change local guidelines for transfusion. There is need for regular audit to improve transfusion practices in a health care set up. A type and screen policy for routine surgeries and obstetric patients should be implemented to save valuable time and resources in developing countries.