Successful creation of an electronic decision support tool to educate clinicians and develop a database to monitor the appropriate use of blood components at Burton Hospitals NHS foundation trust
In the UK 2.9 million blood components are issued every year and only 4% of the eligible population give blood. When used safely and appropriately, blood transfusion saves and improves patient's lives however it is not risk free as death and major morbidity can occur when things go wrong with transfusion. The national audits show that 15-20% of red blood cell transfusions and 20-30% of plasma/platelets transfusions are inappropriate. One of the methods to restrict the inappropriate use of blood and blood component is through an electronic decision support tool to provide education at the point of requesting blood product with feedback message. The use of National Blood Transfusion Committee (NBTC) indicationcodes allow accurate audit Aims: The principal aim was to create an electronic decision support system with feedback messages based on the selection of the indication codes for transfusion to assist with appropriate use of blood products. Methods: Using our electronic patient record system (Meditech) a new custom defined screen wascreatedas a step in the blood ordering processto support decision making. The indication codes for the use of blood components recommended by National Blood Transfusion Committee were included as part of ordering process. The electronic decision support system allows us to integrate the codes in the ordering process. Feedback messages were programmed to provide information on the use of blood component. To capture this data a functional database was created from the Meditech data repository application. This functional live database includes the reason for transfusion, patient's recent Hb level, indication codes, ordered by and other parameters required for monitoring the appropriate use of blood and blood components. Results: We have successfully created a custom defined screen to help the clinicians make the right decision on the appropriateness of blood and blood component transfusion. A live functional database has been created to monitor the use of blood components. The data from this database will be used to provide feedback to other teams. Conclusion: Decision making on the appropriate use of blood components is a critical process and should be based on the clinical findings, laboratory parameters and in line with national guidelines. We believe the use of newly created electronic decision support system as part of the blood ordering process can help clinicians to make the correct decision. The database will provide further insight in to the ordering behaviour of clinicians which we believe will help the Hospital Transfusion team to monitor the use of blood components. Although this was created with Meditech electronic patient record system the same method and principle can be applied to other electronic patient record systems.