Korean J Blood Transfus.  2013 Aug;24(2):111-120.

Reduction of Perioperative Fresh Frozen Plasma Wastage and Transfusion by Quality Improvement Activity

Affiliations
  • 1Graduate School, Seoul National University College of Medicine, Seoul, Korea.
  • 2Department of Anesthesiology, Seoul National University Dental Hospital, Seoul, Korea. aws@snu.ac.kr
  • 3Department of Clinical Pathology, Seoul National University Hospital, Seoul, Korea.
  • 4Department of Anesthesia and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

BACKGROUND
Empirical use of fresh frozen plasma (FFP) in perioperative blood transfusion leads to high wastage of FFP. However, coordination of many related clinical departments is difficult. Therefore, quality improvement (QI) activities for establishment of appropriate use of FFP are needed.
METHODS
Departments of surgery (all surgery departments except ophthalmology) and the departments of anesthesiology, clinical pathology, and nurses met each month from March, 2011 to October, 2011. Each department investigated the number of FFP usages, wastage, and coagulation tests. Primary measured variables and objectives were decrease of 50% of FFP wastage rate compared with the previous year and 50% increase of coagulation testing before using FFP. Secondary measured variables were total amount of FFP usage and report time for coagulation tests.
RESULTS
After the QI activities (March, 2011~October, 2011), FFP wastage decreased, from 71.5 units during the second half of 2010 to 37.8 units during the second half of 2011 (-47.1%). Rate of coagulation testing before using FFP more than doubled during the second half of 2011 (57%) compared with the second half of 2010 (25%). The rate of less than 30 minutes report time for coagulation testing increased from 60% to 75%. FFP transfusion per 1,000 surgical cases decreased to from 190 units to 118 units.
CONCLUSION
Rate of FFP wastage and transfusion decreased and rate of performance of the blood coagulation test was enhanced through education and training on transfusion and QI activities.

Keyword

Fresh frozen plasma; Quality improvement; Wastage of blood products; Coagulation test

MeSH Terms

Anesthesiology
Blood Coagulation Tests
Blood Transfusion
Pathology, Clinical
Plasma
Qi
Quality Improvement
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