Reducing transfusions in critically injured patients using a restricted-criteria order set.
In this study, the authors deal with the problem of adherence to evidence-based transfusion criteria. As they correctly state, in a large hospital it is difficult to achieve homogeneous adherence to transfusion criteria set by a small group of physicians (who, by the way, use evidence-based criteria and guidelines).
In fact, few interventions have been shown to improve adherence to established transfusion criteria. The most successful approaches have been the systemic approaches such as decision support systems, computerized order entry and formal staff educational programmes.
Using a prospective before-and-after study design, the authors evaluated the impact of a hospital-specific order set forcing each physician who wanted to transfuse adult trauma patients to provide specific reasons for the transfusion need. A significant decrease in the transfusion rate was achieved using this approach.
– Rolf Rossaint