Investigation Of The Rationality Of Red Blood Cell And Plasma Transfusion In Third-grade General Medical Institutions From 2013 To 2014 In Anhui Province

Objective To evaluate the rationality of red blood cell and plasma transfusion in third-grade general medical institutions in Anhui Province, and to analyze the present situation and problems of blood rational use, and provide reference for the further improvement of rational blood transfusion and the formulation of relevant policies, based on analysis of red blood cells and plasma using and investigation of clinical doctors' blood rational use mastery in 32 third-grade general medical institutions in Anhui Province from 2013 to 2014.Methods The use of red blood cells and plasma in 32 third-grade general medical institutions in Anhui Province from 2013 to 2014 were retrospectively surveyed. According to the simple random sampling method, each medical institution randomly selected 30 transfusion medical records each year, a total of 1920 blood medical records were selected in two years, including 3623 times of red blood cell transfusion and 1604 times of plasma infusion. The rationality of evaluation criteria was set according to "clinical blood transfusion technical specifications". Then the use rationality of red blood cells and blood plasma in clinical departments was evaluated. The using clinical differences were analyzed in various clinical departments.In order to investigate the clinicians' mastery of related knowledge about rational use of blood,320 clinicians were selected from 10 departments in surgical and medical systems in 32 third-grade general medical institutions in Anhui Province, with the method of stratified sampling method. Then 320 clinicians were Organized to carry out the closed book examination.Results In 32 third-grade general medical institutions in Anhui Province, the rational use of red blood cells in 2013 were 68.72% in surgical departments and 98.51% in medical departments. The rational use of plasma in 2013 were 18.50% in surgical departments and 30.52% in medical departments. The rational use of red blood cells in 2014 were 67.38% in surgical departments and 96.10% in medical departments. The rational use of plasma in 2014 were 22.29% in surgical departments and 46.93% in medical departments. All differences were significant. There were statistically significant differences about the use rationality of red blood cells and plasma among different departments in surgical systems and medical systems from 2013 to 2014.There were statistically significant differences in different departments about three kinds of irrational use of red blood cells (lack of blood transfusion indications, loose blood transfusion indications and blood transfusion for non-treatment need). There were statistical differences in different departments about six kinds of irrational use of plasma (Supplementary protein, therapy supporting or simple supplementary nutrition, and 1:1 collocation infusion with red blood cell, blood transfusion for non-treatment need, blood transfusion without transfusion basis and promoting wound healing). There were statistically significant differences in the grasp of blood transfusion indications and basic knowledge about the rational use of blood in different departments.Conclusion The third-grade general medical institutions in Anhui Province had a good grasp of the red blood cell transfusion indications. The rational use of red blood cells was much higher than that of plasma. There were significant differences about the use rationality of red blood cells among different departments in surgical and medical systems. The rationality of red blood cells use was in a higher level, but the use of plasma is unreasonable. However, the rationality of plasma use increased by 8.96% in 2014 compared with that in 2013. There is a big space for improvement. So the clinical doctors have to improve the understanding of the plasma using in the concept and adaptation. With publicizing and popularization of blood transfusion technical specifications and Supervision by competent department of health, the rationality of clinical blood using will be gradually improved.