Improving blood-prescribing decisions: Evaluating the efficacy of a blood guidelines app.
Transfus Med
; 30(6): 485-491, 2020 Dec.
Article
em En
| MEDLINE
| ID: mdl-33184992
ABSTRACT
OBJECTIVES:
To assess the effect of an app providing national blood transfusion guidelines on prescribing decisions.BACKGROUND:
National, regional and local audits in England consistently show inappropriate use of all blood components; around 15%-20% of red blood cells (RBC) and 20%-30% of platelets and fresh frozen plasma (FFP). Hospital transfusion guidelines may be difficult to locate and not agree with national guidelines. We developed and tested a dedicated app providing national evidence-based guidelines for use at the point of care to help clinicians make better decisions when authorising blood. METHODS/MATERIALS We identified areas of blood authorisation with high frequency of component use and evidence of widespread unnecessary authorisation. We developed seven representative clinical scenarios where the transfusion of blood components may or may not benefit the adult patient. Responding doctors were invited to select their authorisation choice via an online questionnaire, initially without and then with access to the app. Adherence to guidelines was assessed with and without aid of the app.RESULTS:
Using the app, doctors were much more likely to select the correct decision, in accordance with national guidance. Compared with baseline measurements, decisions improved by 67% for RBC, 58% for platelets and 73% for FFP. These improvements were statistically significant.CONCLUSION:
Apps such as "Blood Components" can help doctors do "the right thing rather than the wrong thing". Further studies are required to assess the impact of using the app in clinical practice and the effect on blood component management and financial savings.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Médicos
/
Transfusão de Componentes Sanguíneos
/
Aplicativos Móveis
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Tomada de Decisão Clínica
/
Hospitais
Tipo de estudo:
Evaluation_studies
/
Guideline
/
Prognostic_studies
/
Qualitative_research
Limite:
Adult
/
Female
/
Humans
/
Male
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article