Background Preterm infants frequently require multiple blood transfusions. Splitting adult units into 6–8 satellite packs has been universally adopted by neonatal units to reduce donor exposure. Our NICU guideline is to request satellite packs for infants ≤28 weeks gestation or birthweight ≤1000 g. A previous audit demonstrated poor policy implementation due to inadequate communication between clinicians and laboratory staff. Strategies to improve this included a) introduction of a transfusion sheet highlighting the need for satellite packs in 2010, b) move from paper to electronic requests in March 2012.
Aim The aim of this study was to investigate: a) whether interdepartmental communication has improved, b) that this has optimised use of satellite packs.
Method All infants 28 weeks gestation or less born between April–December 2012 inclusive were reviewed. We examined a) whether the transfusion request identified the need for satellite packs, b) number of blood transfusions for each infant, c) number of donor exposures for each infant. Data was compared to a similar cohort of babies born in 2011.
Results Data was available in 43 infants born in 2011 and 53 infants born in 2012. Satellite pack request data was available for all infants born in 2012 and 40 infants born in 2011.
Conclusion Electronic requests enabled successful identification of all eligible infants to laboratory staff. However this did not result in a reduction in donor exposure. Further discussions revealed that all satellite packs were re-allocated within a few days if not used. Increasing laboratory staff awareness of the specific needs of the preterm infant facilitated change within laboratory practice aimed at retaining satellite packs for extreme preterm infants. Good communication and interrogation of every step of the pathway is vital to effect successful quality improvement change.
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