One year clinical audit of the use of blood and blood components at a tertiary hospital in Nigeria

Abstract

The appropriate use of blood and blood components remains a formidable challenge faced by clinicians particularly in a developing country like Nigeria. The inadequate supply of safe blood implies that measures aimed at ensuring judicious use of the available supply should be continually identified and explored. Aprospective study to evaluate all blood and blood component transfusions over a period of one year from January to December 2004 was done. The appropriateness of the transfusion with respect to the clinical state and the transfusion needs of the recipientwas assessed by aHaematologist. A total of 682 transfusion episodes were reviewed and analyzed. The commonest indication for use blood/blood componentwas severe anaemia in 38% of cases.Twenty nine percent of transfusions formoderate anemia, and 36%of fresh frozen plasma transfusions were found to be unnecessary. Inappropriate transfusion ismostmarked in the setting of platelet transfusionwith81%of platelet transfusion being inappropriate. Enhanced capacity for component preparation, regular auditing of transfusion practices aswell as improved communication between the clinicians and laboratory physicians will lead to more judicious use of blood component therapy. The need for the development of guidelines for blood component use in hospitals in
linewith the national blood transfusion policy is highlighted.

Keywords: Clinical audit;Blood components; inappropriate transfusion.