Authors: Puthida Tantanapornkul, Kriengsak Jenwitheesuk, Kutcharin Phunikhom, Thipaporn Jaroonsirimaneekul.
Background: Cross match to transfused ratio (C/T ratio) in 2015 in Srinagarind hospital was 1.6, the Red cells (RC) unit requested 33,508 units, transfused 22,951 units and returned to Blood Bank 10,557 units. 60% for RC supply brought wastes in blood expired and work load. There lead us to implement new method and set Type and Screen channel for un-risk diagnosis. And blood logistics was started at end of 2015 for transfer the RC units to the wards. The diagnosis and hematocrit of patients must be considered for cross match.
Objectives: (I) To evaluate transferred to transfused ratio (T/T ratio) in patient’s diagnosis, count on transfused units and the result will lead to reduce blood inventory and decrease blood wastage and budget for blood stocking. (II) To understand the diagnosis scope of RBC cross matching and issuing practices and measure efficiency using a novel quality indicator.
Methodology: RC units transfer by logistic system was collected in September 2016 to May 2018. The data was defined into diagnosis, unit cross matched and monitored transfer to transfuse ratio (T/T ratio).
Results: (I) Finding: C/T ratio from 2015 to 2018 were 1.72, 1.72, 1.68 and 1.68, respectively and T/T ratio for all RC transfer has calculated to 1.3, 1.3, 1.4 and 1.4, respectively. From 53 wards in tertiary hospital, 38 wards (71.7%) has T/T ratio <1.5; were intensive care units (MICU, PICU, SEICU, CCU, CVT ICU, NICU, NSICU), semi crisis units, chemotherapy patients, radiotherapy patients. In specific diagnosis found patients with severe or life-threatening illness (admit in ICU) and cancer treatment have T/T ratio closed to 1 (1.17-1.27). T/T ratio more than 1.5 (28.3%) for orthopedics and stenosis, eye disease, emergency injury and trauma, general practice and general surgery, and organ transplant have T/T ratio 1.51 to 1.85. The abdominal surgery found highest T/T ratio (3.33), and general surgery found T/T ratio 2.38.
Conclusion and Discussion: T/T ratio lowers than C/T ratio 37%. The data found 28.3% from 53 wards can consider for on call matching, to decrease work load and blood stocking. The expense from cross matching and blood inventory can provide to other plan for therapeutic support. The abdominal surgeries, general surgery, labour room, pre and post operation should be considered in type and screen.
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