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Restrictive transfusion strategy and clinical decision support practices for reducing RBC transfusion overuse
H Derzon, J., Clarke, N., Alford, A., Gross, I., Shander, A., & Thurer, R. (2019). Restrictive transfusion strategy and clinical decision support practices for reducing RBC transfusion overuse. American Journal of Clinical Pathology, 152(5), 544-557. https://doi.org/10.1093/ajcp/aqz070
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.