Restrictive Transfusion Strategy and Clinical Decision Support Practices for Reducing RBC Transfusion Overuse A Laboratory Medicine Best Practice Systematic Review and Meta-Analysis

被引：17

作者：

Derzon, James H. ^{[1
]}

Clarke, Nicole ^{[2
]}

Alford, Aaron ^{[3
]}

Gross, Irwin ^{[4
]}

Shander, Aryeh ^{[5
]}

Thurer, Robert ^{[6
]}

机构：

[1] RTI Int, Res Triangle Pk, NC 27709 USA

[2] Pharmerit Int, Bethesda, MD USA

[3] Natl Network Publ Hlth Inst, Washington, DC USA

[4] Acumen, San Diego, CA USA

[5] Englewood Hosp & Med Ctr, Englewood, NJ USA

[6] Gauss Surg, Los Altos, CA USA

来源：

AMERICAN JOURNAL OF CLINICAL PATHOLOGY | 2019年 / 152卷 / 05期

关键词：

Restrictive transfusion strategy; Computerized physician order entry; Clinical decision support; RBC transfusion; Systematic review; Meta-analysis; BLOOD-CELL TRANSFUSION; PHYSICIAN ORDER ENTRY; CARDIAC-SURGERY; OLDER-ADULTS; MANAGEMENT; REQUIREMENTS; TRIAL; HIP; OUTCOMES; CARE;

D O I：

10.1093/ajcp/aqz070

中图分类号：

R36 [病理学];

学科分类号：

100104 ;

摘要：

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. Conclusions: 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.

引用

页码：544 / 557

页数：14

共 62 条

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