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临床试验/NCT04823273
NCT04823273已完成不适用

Blood Transfusion Reduction Quality Improvement Project

University of Colorado, Denver2 个研究点 分布在 1 个国家目标入组 1,640 人开始时间: 2021年4月6日最近更新:
适应症

试验速览

阶段
不适用
状态
已完成
入组人数
1,640
试验地点
2
主要终点
Blood Transfusion Orders

研究概览

简要总结

Blood Banks of large medical centers have large annual budgets, typically millions of dollars. Blood product wastage results in not only in a loss of the product's cost, but also of the fees involved in transporting, handling, and administering these products. Optimal utilization of blood products requires a balance between maximizing patient clinical outcomes while avoiding unnecessary costs and risks associated with transfusions. This project will specifically focus on packed red blood cell transfusions (pRBCs). There are clear guidelines for transfusing pRBCs however these guidelines are not always followed. pRBC transfusions outside of recommended guidelines is associated with increased risk of harm to patients.

Our aim is to improve adherence to guideline indicated pRBC transfusions for patient in the UCHealth system thereby decreasing inappropriate (non-guideline indicated) pRBC transfusions. We will conduct a QI project seeking to improve pRBC transfusion guideline adherence. This project will involve data review to establish baseline rates, multimodal interventions to improve adherence to pRBC transfusion guidelines including provider education, modifications to the electronic ordering interface, and changing blood back policies at participating institutions.

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
主要目的
Health Services Research
盲法
Single (Participant)

入排标准

性别
All
接受健康志愿者

入选标准

  • All physicians and nurses with access to order inpatient blood transfusions through a hospital-based EMR.
  • All physicians and nurses ordering blood for individuals over the age of 18.

排除标准

  • All physicians and nurses ordering blood transfusion ordering blood in the OR
  • Blood ordered through massive transfusion protocol

结局指标

主要结局

Blood Transfusion Orders

时间窗: 78 weeks

Number of patients who received blood transfusions during the study by arm.

Guideline Concordance Measured by Pre-Transfusion Hemoglobin Values Per Transfusion

时间窗: 78 weeks

The American Association of Blood Banks recommends a restrictive threshold of a pre-transfusion hemoglobin level of less than 7.0g/dL for the vast majority of inpatients. Transfusions with Hemoglobin levels above 7 will be compared in arm 1 vs 2 +3 combined; arm 2 vs arm 3.

Guideline Concordance Measured by Number of Units Ordered Per Transfusion

时间窗: 78 weeks

The American Association of Blood Banks recommends a restrictive threshold of a single unit pRBC transfusion for the vast majority of inpatients. This outcome will compare hemoglobin levels, units transfused in arm 1 verses arms 2 and 3 combined and arm 2 verses arm 3.

次要结局

未报告次要终点

研究者

申办方类型
Other
责任方
Sponsor

研究点 (2)

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