Research

Resource implications of adopting a restrictive neonatal blood transfusion policy

M C Harrison, S Pillay, Y Joolay, N Rhoda, M S Raban, A R Horn, L Tooke

Abstract


Background. Blood transfusions (BTFs) are not without risk and pose a significant financial burden on resource-limited services. In line with current international evidence, the nursery at Groote Schuur Hospital (GSH), Cape Town, South Africa, introduced a restrictive BTF protocol to minimise transfusions and manage costs.

Objective. To determine whether adopting a restrictive BTF policy results in fewer transfusions.

Methods. Data were retrospectively collected on all infants who received BTFs in the GSH nursery over a 6-month period following adoption of a restrictive BTF policy in 2010. BTF figures for a similar time period before the restrictive policy, during 2008, were obtained for comparison.

Results. After introduction of the restrictive BTF policy, 42 of 1 097 infants admitted (3.8%) received a total of 64 BTFs. In comparison, 102 of a total of 940 infants (10.9%) admitted during a period of the same length before introduction of the restrictive BTF policy received a total of 121 transfusions. Comparison between the number of BTFs administered before and after the restrictive policy showed a highly statistically significant difference (p<0.001). The total cost of the blood products used in the two 6-month periods was R91 870 v. R48 640, based on current prices.

Conclusions. By adopting a restrictive policy, we were able to halve the number of BTFs, reduce risks associated with transfusions, and achieve significant cost benefits. Following evidence-based guidelines results in high standards of care, while also making the most effective use of resources. 


Authors' affiliations

M C Harrison, Neonatal Medicine, Department of Paediatrics, University of Cape Town, South Africa

S Pillay, Neonatal Medicine, Department of Paediatrics, University of Cape Town, South Africa

Y Joolay, Neonatal Medicine, Department of Paediatrics, University of Cape Town, South Africa

N Rhoda, Neonatal Medicine, Department of Paediatrics, University of Cape Town, South Africa

M S Raban, Neonatal Medicine, Department of Paediatrics, University of Cape Town, South Africa

A R Horn, Neonatal Medicine, Department of Paediatrics, University of Cape Town, South Africa

L Tooke, Neonatal Medicine, Department of Paediatrics, University of Cape Town, South Africa

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Keywords

neonatal; blood transfusions; clinical resources; evidence-based medicine

Cite this article

South African Medical Journal 2013;103(12):916-917. DOI:10.7196/SAMJ.6858

Article History

Date submitted: 2013-03-04
Date published: 2013-09-03

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