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Lee M. Duke, MD
Editor-in-Chief
(717) 544-5145
lmduke@lghealth.org

Mary Beth Schweigert
Managing Editor
Corporate Communications Specialist
(717) 544-5093

MSchweigert2@lghealth.org


 
Healthcare Professionals / Progress Notes / Quality/Risk Management / A successful year in patient blood management, at LG Health

 
A successful year in patient blood management, at LG Health
8/15/2014

By: Mary Bassalin, BS, RN, CCRN

With an increased focus on patient-centered decisions regarding blood products and the implementation of single-unit transfusion orders, Lancaster General Health is successfully managing our blood product supply. For that, we thank you.
Red blood cell transfusions have decreased by over 15 percent in the past year, and transfusions in patients with a hemoglobin > 7 gm/dL decreased from over 57 percent in 2013, to 41.5 percent.

A contributor to our success this year was the implementation of TEG® (thrombelastography) into Cardiac Surgery and Trauma services. This device allows surgeons to manage coagulopathies by displaying the clotting process a patient is experiencing. By targeting treatments, coagulopathies can be treated in a more direct and focused manner. Cardiac Surgery is also using the instrument to identify patients who do not respond to Plavix, allowing surgeries to be performed earlier than the typical five-day waiting period.

Orthopedics has continued to drive down their transfusion rates in geriatric fracture and joint replacement patients. In 2012, the red cell transfusion rate was 45% in geriatric fracture patients and 17% in joint replacement patients. Through increased awareness of the current evidence and practices, collaborating with Internal Medicine, and setting aggressive goals, Orthopedics decreased transfusions to 36% in 2013 and 27% in 2014 in geriatric fracture patients; joint replacement patients decreased to 9% in 2013 and 7.6% in 2014. 

This coming year we will focus on the importance of anemia management in all of our patients. This includes those who may not be hospitalized, but are being seen by primary care physicians both in and out of the hospital. We will continue to offer current evidence to physicians who order transfusions outside of the hospital’s current transfusion guidelines.

We look forward to helping you and your patients. If you have concerns or would be interested in the current evidence regarding blood product transfusions in your area of specialty, please feel free to contact me (mabassal@lghealth.org) or Susan Bator, MD, (smbator@lghealth.org).



 
 

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