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A close-up of a syringe needle inserted into a vial, with a blue-toned background, suggesting a medical or vaccination context.

Restrictive transfusion strategy and clinical decision support practices for reducing RBC transfusion overuse

Authors: J Derzon H, N Clarke, A Alford, I Gross, A Shander, R Thurer

Published: American Journal of Clinical Pathology, 2019

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Objectives

Assess support for the effectiveness of two separate practices, restrictive transfusion strategy and computerized physician order entry/clinical decision support (CPOE/CDS) tools, in decreasing RBC transfusions in adult surgical and nonsurgical patients.

Methods

Following the Centers for Disease Control and Prevention Laboratory Medicine Best Practice (LMBP) Systematic Review (A-6) method, studies were assessed for quality and evidence of effectiveness in reducing the percentage of patients transfused and/or units of blood transfused.

Results

Twenty-five studies on restrictive transfusion practice and seven studies on CPOE/CDS practice met LMBP inclusion criteria. The overall strength of the body of evidence of effectiveness for restrictive transfusion strategy and CPOE/CDS was rated as high.

Conclusion

Based on these procedures, adherence to an institutional restrictive transfusion strategy and use of CPOE/CDS tools for hemoglobin alerts or reminders of the institution’s restrictive transfusion policies are effective in reducing RBC transfusion overuse.