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Oncology and haematology

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ONC/THUR/01 RIGHT PRODUCT, RIGHT PATIENT, RIGHT TIME: MEDICAL STAFF AND THEIR UNDERSTANDING OF BLOOD PRODUCT USE IN A PAEDIATRIC HAEMATOLOGY/ONCOLOGY UNIT

J Aspel, K Wheeler, G Hall. The Childrens Hospital, Oxford, UK

Background: Blood products are prescribed and administered on a daily basis in all paediatric haematology/oncology units. Although most products are prescribed routinely, there will be many occasions when they will need to be prescribed out of hours. As a consequence, staff that are not part of the dedicated haematology/oncology team are involved in the prescribing of blood products.

Aims: To explore the depth of knowledge and understanding of blood products and their indications for use among junior medical staff in a teaching hospital paediatric department that contains a haematology/oncology unit but without dedicated juniors out of hours. Regular queries regarding blood product administration to consultants covering the unit precipitated this study.

Methods: Questionnaires were distributed to junior medical staff in the paediatric department. This covered basic knowledge of transfusion medicine, the use of special blood products, the use of departmental guidelines and personal confidence in ordering and prescribing.

Results: 29 questionnaires were distributed with 21 returns, from 15 specialist registrars and six senior house officers. Three doctors (14%) prescribed blood products on a weekly basis and 16 (76%) prescribed monthly. Only 85% of respondents had an accurate understanding of the ABO system and knowledge about blood product storage and administration was variable. Only four, (19%) had heard of the serious hazards of transfusion (SHOT) group. Only a quarter of the respondents were clear about which patients required cytomegalovirus-negative or irradiated products. Less than a third of respondents had read the departmental guidelines. Of those doctors that did prescribe, 75% felt confident to do so. Three (14%) had had previous experience of paediatric haematology/oncology in a different institution.

Conclusions: The use of blood products should always be carefully considered and doctors must be able to understand and justify their practice. …

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