Patient blood management: how is implementation going?: A report comparing the 2015 survey with the 2013 survey of PBM in England.

BACKGROUND

Patient blood management (PBM) is an evidence-based approach to optimising the care of patients who might need transfusion. In 2013, all NHS Trusts in England were surveyed about their readiness to implement PBM. National PBM recommendations were launched in 2014.

AIMS: The aim of this study was to determine progress of PBM initiatives.

METHODS/MATERIALS: A survey was constructed by staff in hospitals and NHS Blood and Transplant (NHSBT). An online questionnaire was sent to all NHS Trusts in England (N = 149) in November 2015.

RESULTS

Improvements in 2015: Education/training in transfusion: 80-100% from 60-90% in 2013 Provision of information relating to consent for transfusion: 98% from 65% in 2013 (P = <0·001) The management of anaemia: elective general surgery management, 66% from 41% in 2013 (P = <0·001) Transfusion alternatives: Tranexamic use in surgery, 92% from 71% in 2013 (P = <0·001) Laboratory staff empowered to challenge transfusion requests, 95% from 65% in 2013 (P = 0·001) Further work required: Electronic systems to support requesting (e.g. mandatory recording of diagnosis: 47% from 48% in 2013 (P = 0·85), incorporation of standardised requesting codes: 27% from 33% in 2013 (P = 0·24) Appropriate use of components: in 2015, only 42% had a lower red cell transfusion thresholds policy in non-bleeding patients

CONCLUSIONS

The results provided information to support the development of local and national work plans. It is hoped that the collaborative work across NHS Blood and Transplant (NHSBT), the National Blood Transfusion Committee (NBTC) and NHS Trusts will continue to drive the PBM agenda to support best practice in this field.