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An audit of the use of platelet transfusions at Universitas Academic Hospital,Bloemfontein, South Africa
Authors:P.H. Sonnekus  V.J. Louw  A.M. Ackermann  C.L. Barrett  G. Joubert  M.J. Webb
Affiliation:1. Department of Internal Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa;2. Division of Clinical Haematology, Department of Internal Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa;3. Department of Anaesthesiology, School of Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa;4. Department of Biostatistics, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa;1. University of California, Irvine School of Medicine, Irvine, California;2. Division of Adult Reconstruction, Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, NYU Langone Medical Center, New York, New York
Abstract:An audit was performed at a tertiary hospital in Bloemfontein, South Africa, to establish whether clinicians adhered to local platelet transfusion guidelines. The audit showed poor compliance with local guidelines, with 34% of platelet transfusions not aligned with guidelines and 29.9% of transfusions administered to patients with platelet counts of ≥150 × 109/L. When compared to medical disciplines, surgical disciplines tended significantly more to transfuse platelets inappropriately (17.1% and 53.7%, respectively; p < 0.0001). Documentation was poor and in 48.4% of orders for platelets, the indication for the platelet transfusion was not clearly stated. Considerable cost could be avoided with improved adherence to guidelines. This study emphasises the need for improving education in transfusion medicine amongst medical doctors. It is hoped that the information gleaned from this study would assist in the design of educational programmes in transfusion medicine as we attempt to close the existing gaps in knowledge and skills in the field, while ensuring that blood is transfused in a cost-effective and appropriate manner.
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