RTC DATABASE April 2014 March 2015 Dedicated Tx Sessions HTC - PowerPoint PPT Presentation

RTC DATABASE April 2014 – March 2015

Dedicated Tx Sessions • HTC Chair – 7 shared sessions with the role of CH responsible for Tx • TLM – range between 1-10, with 2/3rds 10 • TP – range between 1-15 • CH for Tx – 4 with no sessions

HTC Attendance By Specialty Always Frequently Sometimes Never NA Medicine (excl. 1 5 5 7 0 Haematology) Haematology 14 4 0 0 0 Anaesthetics 10 5 1 2 0 Obs & Gynae 2 8 5 3 0 Surgery 1 6 6 5 0 Orthopaedics 0 4 5 9 0 Emergency Department 1 6 7 2 2 Clinical Governance 3 3 3 9 0

Make Transfusion Safer

Induction Training (18 hospitals provided data) Induction Training 19 17 15 No. of Hospitals 13 Yes 11 Gave % Trained 9 >75% Trained 7 5 3 1 e P t s A s s n e e r C t D e e n s s n O H i i r t m a r a u / o r N s m o T P e t o r s l a e b r c P u e i N d l l h a e P e c M r i d t a e e M h T

Regular Training (18 hospitals provided data) Regular Training 19 17 15 No. of Hospitals 13 Yes 11 Gave % Trained 9 >75% Trained 7 5 3 1 e t s A P s s n e e D r C t e s e n s O n H i r i t a m r a u / o r s m N o T P e t r o l s a e b r P u c e N i d l l h a e P e c M r i d t a e e M h T

LIMS System Supports Electronic Dispatch Note <300 300-800 >800 Yes 2 6 1 No 1 6 2 If Yes, do you use EDN Yes 1 5 1 No 1 1 0 Electronic / Radiofrequency technology throughout tx process <300 300-800 >800 Full / Part Full / Part Full / Part Yes 1 / 1 5 / 5 0 / 1 No 1 2 2

Laboratory Information All CPA and NEQAS compliant 10 not yet UKAS accredited

Electronic Issue 2011 81% (17 out of 21) 2012 79% (15 out of 19) 2013 79% (15 out of 19) 2014 84% (16 out of 19) 2015 89% (16 out of 18) Electronic Pathology Requesting Group & Save 28% ( 5 out of 18) Crossmatch 17% ( 3 out of 18)

Request for Transfusion where indication unclear usually challenged Requests Challenged by Staff 9 8 7 6 No. of Hospitals 5 Yes No 4 3 2 1 0 <300 300-800 >800

RBC Issues 20000 2004/200 5 18000 2005/200 6 16000 2006/200 7 2007/200 14000 8 2008/200 12000 9 2009/201 10000 0 2010/201 8000 1 2011/201 6000 2 2012/201 4000 3 2013/201 2000 4 2014/201 0 5 r . l y H n t y e . H . n H h E B d e l i e d t t c o v e a l l o t o r l & r t e l C u W C a H o s u o e b a e t p o s t t D h e r o h o n e x s a b r B R B U f G o i C o i Y e P C l u m E r s G R r t R B D r s T H W i a l e h . n a . U f T f e D t f r S f u u a u r R i o p N B N S S

Platelet Issues 5000 2004/200 5 4500 2005/200 6 4000 2006/200 7 2007/200 3500 8 2008/200 3000 9 2009/201 2500 0 2010/201 2000 1 2011/201 1500 2 2012/201 1000 3 2013/201 4 500 2014/201 5 0 Nuff. Exeter Yeovil Torbay Nuff. Chelt. Glouc. Dorset GWH Taunton Chelt. RUH Bath RD&E RCH Derriford Weston Salisbury Poole RBCH UHB Spire Bristol Barnstaple Southmead

General Patient Blood Management Yes No NG Depts use EPO as alternative to tx 11 7 0 Trust has tx triggers 15 3 0 Are these in line with NBTC Codes 14 0 1 Guidelines incorporate Single unit use 15 3 0

Surgical Patient Blood Management Pre-Operative Assessment Provide Point of Care Testing Identify & Provide Identification Measurement of Treat Information of Hb clotting Anaemia Leaflets parameters Trustwide 13/18 15/18 7/18 2/18 Specific 1/5 0/3 10/11 7/16 Departments

Cell Salvage Provide Intra Operative Cell Salvage Use Post Operative Cell Salvage During Routine Out of Hours working Hours 71% 63% 71% 2007 2008 80% 75% 65% 2009 68% 55% 82% 2010 79% 53% 74% 2011 71% 52% 71% 2012 79% 63% 68% 2013 68% 63% 58% 2014 74% 58% 58% 83% 67% 22% 2015 Is tranexamic Acid used: YES: 16 NO: 2

Medical Patient Blood Management Identify & Treat Anaemia Provide Information Leaflets Trustwide 8/18 14/18 Specific 6/10 2/4 Departments

Use of rFVIIa 2007 2008 2009 2010 2011 2012 2013 2014 2015 Hospital Stocks 13 14 14 14 13 13 12 13 13 Haemophilia 1-5 10 9 11 7 6 6 7 10 9 6-10 0 1 0 0 1 1 1 1 1 >10 2 2 1 2 3 2 1 1 2 Non- 1-5 12 11 11 12 12 12 10 9 10 Haemophilia 6-10 2 3 2 1 0 0 0 - - >10 1 1 2 0 0 1 1 1 1 PCC - all NHS + 1 private hospital stocks and none said did not use

Obstetric Practice (NHS Hospitals Only) 15 NHS hospitals gave a Single Dose 28 – 30 weeks 1 did not answer % Issued Traceable to Named Patient • 9 -100% • 6 - > 95% • 1 - >90% 15 hospitals had a Strategy/Policy to identify and treat maternal anaemia

Summary • Participation all but one NHS & 2 private hospitals • Structure – • All hospitals have HTT • In 4 NHS hospitals CH has no dedicated sessions • No HTC attendance – anaesthetics, surgery, orthopaedics, CG plus NHS hospitals medicine & ED • Regular training – only 6 achieve >75% for permanent medical staff • Electronic -issue ~90%, requesting <30%, full/part blood tracking >70%, EDN 50% • RBC annual issues � 2.9%, platelet issues � 4.7% • PBM – 3 no strategy to use single unit RBC’s • PBM surgical – some hospitals no pre-op anaemia management, leaflets or TXA use. IOCS � , post op CS �