REQUESTS OF APHARESIS PLATELET CONCENTRATES IN THE TUNISIAN NATIONAL CENTER OF BLOOD TRANSFUSION
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Transcript of REQUESTS OF APHARESIS PLATELET CONCENTRATES IN THE TUNISIAN NATIONAL CENTER OF BLOOD TRANSFUSION
REQUESTS OF APHARESIS PLATELET CONCENTRATES IN THE TUNISIAN NATIONAL
CENTER OF BLOOD TRANSFUSION
ASMA RYM BEN ROMDHANE
MAY 2012
INTRODUCTION
In Tunisia: Legislative recommendations 49/05 Manual of procedures for managing blood and its
components :
National guidelines for platelet component requests
The Aim: Evaluation of platelet requests by determining their compliance to these national guidelines
MATERIALS & METHODS
Prospective study
Extended on 20 days (02/03/12 to 21/03/12)
Every request for platelet transfusion from different public and private institutions in the capital was daily analyzed.
RESULTS
•20 DAYS•140 REQUESTS FOR PLATELET TRANSFUSION
•135 APC DISTRIBUTED•=> 7,5 + 4 APC/DAY
•63 TRANSFUSED PATIENTS•=>2,14 APC/ PATIENT
• AVRAGE AGE = 38 years [1,25 - 96] •SEX RATIO (M/F) = 2,85
GENERAL FEATURES
0%
50%
100%
DATE OF BIRTH MISS-INGtégorie 1; Série 1; 80.2%
AGE MISSING; Série 1; 34.0%
DATE OF BIRTH/AGE
Missing; Série 1; 14.0%
GENDER MISS-ING; Série 1;
7.0%
WEIGHT MISS-ING; Série 1;
99.0%
DIAGNOSIS MISSING;
Série 1; 4.2%
PLATLET COUNT MISS-ING; Série 1;
51.0%
NON CONFORMITIES RATE
RATE OF PLATLET&
APC TRANSFUSION
Platelet Count 0%
20%
40%
60%
80%
100%
Platelet Count ; Missing;
51%
Platelet Count ; Present;
49%PresentMissing
?
RATE OF PLATLET&
APC TRANSFUSION
0%10%20%30%40%50%60%70%80%90%
100%
PROPHLACTIC TRANSFUSION
CURATIVE TRANSFUSION
INDETERMINED RATE OF PLATLET
82%
18%
51%
14 041/µL
?
17 142/µL[2000-40 000/μL]
[3000-43 000/μL]
APC CONSUMPTION
PUBLIC SECTOR PRIVATE SECTOR0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
PUBLIC SECTOR;
Série 1; 93%
PRIVATE SECTOR;
Série 1; 7%
APC CONSUMPTION IN THE PUBLIC SECTOR
CNGMO AOH OTHERS0%
10%
20%
30%
40%
50%
60%
70%
80%
CNGMO; Série 1; 79%
AOH; Série 1; 16%
OTHERS; Série 1; 5%
COMMENTS
Our results show poor compliance with the current national guidelines.
Clinical information were often missing on the prescription. Some of them were part of legislative requirements or recommendations
CIRCULAR 49/05 FOR BLOOD SAFETY
« Any request for blood or its derivatives will be honored only on written medical prescription. Any request non conform to the model in Annex I will be rejected »
« Toute demande de sang ou de ses dérivés ne sera honorée que sur prescription médicale écrite. Toute demande non conforme au modèle de l’annexe I sera rejetée. »
WEIGHTPLATLET COUNT
COMMENTS
In addition to circular 49/05 recommendations, Manual of procedures for managing blood and its components states that platelet request must include :
The patient’s weight
The platlet count Our study: 99% weight were not 51% platelet count
mentioned
COMMENTS
Reasons explaining this high rate of non-compliance:
Unawareness of the importance of these information in the platelet component prescription
Lack of communication between the hospital transfusion committees / NCBT
A well filled request allows the distributor to deliver the product that best suits the patient’s clinical situation
BEST ADVICE TRANSFUSION
COMPARISONAudit Of The Use Of Platelet Transfusions In The Uk (2007)
Our Study (2011)
Transfused Patient
Institution Number
Period
4421
168
3 Months
63
9
2 Months
Global Non Compliance To The Audit
43% 99%
Diagnosis Missing 7% 4,2%
Platlet Count Missing
Cardiology: 17% 29% Hematology: 32%
Critical care: 21%
51%
Prophylactic Transfusion 57% 82%
COMMENTS
82% Prophylac
tic APC Transfusi
on
Excessive use of a
valuable and
Expensive product
Improve APC
Availability
Better compliance with NG : An APC better use
RECOMMENDATIONS&
CONCLUSION
Guidelines: Written local guidelines, given by hospital transfusion committees, must be available in all clinical specialties where APC are transfused
Communication: Hospital transfusion committees/ NCBT
Education: Training must be provided to physicians
Audit: Hospitals should carry out regular audits of compliance with these guidelines
Improve optimization of APC use
THANK YOU FOR YOUR ATTENTION