Department of Pathology, Stanford University School of Medicine, California, United States
Background/Case Studies:
Universally compatible blood product (UCBP) (group O packed red blood cells (pRBC), and group AB plasma) inventory is a vital resource for blood banks during emergencies. Inappropriate use of UCBP for patients when their specific blood group is available in outpatient settings can lead to unnecessary depletion of this critical resource.
Haemobank (HB) systems facilitate the safe storage, selection and dispensing of pRBCs outside of traditional blood banks, at designated sites (operation room, emergency department etc.), thereby improving the rapid access to blood products.
In this study, we assessed the use of out-of-group pRBCs within Stanford Hospital’s ambulatory infusion treatment area (ITA).
Study
Design/Methods: Data was extracted from two HB units located within the ITA over a six month period. This data was analyzed to gain a better understanding of blood utilization patterns. A survey was designed to evaluate ITA nurses' practices and knowledge surrounding HB utilization. Intervention strategies were developed to reduce the use of out-of-group blood.
Results/Findings:
Data revealed a total of 1,720 pRBC units transfused. The majority of these were group O pRBC (46%), followed by group A pRBC (36%). More detailed analysis showed that 7% of total transfusions were out-of-group transfusions. Additionally, group O pRBCs were used for 13% of group B, 11% of group A, and 7% of group AB patient transfusions (Figure 1).
A survey of 20 nurses showed high comfort with using the Haemobank (HB) and adequate training, but only half avoided using group O blood for non-O patients, often citing compatibility as the reason for selection.
Following this, interventions included staff education and restricting HB from issuing group O pRBCs for out-of-group transfusions. An educational handout was prepared and shared with ITA nursing staff during a daily staff huddle. The purpose of the project, as well as the project implementation date were discussed, and staff questions were addressed.
A month after the go-live date, a total of 198 pRBC units were transfused with no out-of-blood group transfusions, demonstrating the effectiveness of the implemented interventions.
Conclusions: UCBP inventory is critical to prevent treatment delays during bleeding emergencies or for patients with complex transfusion needs. However, inappropriate use can strain this limited resource. This project restricted access to UCBP in HB units at ITA, successfully eliminating unnecessary use. Potential risks of reduced availability were addressed through proactive inventory management and real-time monitoring. The project highlights how interdisciplinary communication and Laboratory Information System based interventions can optimize blood product use and improve transfusion safety.
