AIZA F.

ORONCE NCM 103 TRANSFUSION CONFUSION

Over the years, studies have been comparing the efficacy of blood transfusions and compared a restrictive transfusion strategy (Hg 7-9 g/dL) to liberal transfusion strategy (10-12 g/dL). Studies determined that blood transfusions werent associated with improvements in clinical outcomes, so as a result of this, guidelines for BT were lowered from Hg 10 g/dL to the current level of below 7 g/dL in critically ill patients. But 90% of patients developed anemia as evidenced by subnormal Hg level. Factors that likely to contribute to blood loss include excessive lab blood tests and the usage of large bore cathethers or sheaths, arterial lines and dialysis catheter. Nurses should employ strategies to minimize blood loss especially when a patient is in arterial line such as coordinating multiple tests to be drawn at a single time, monitoring redundancy of tests, and minimizing the amount of blood drawn and blood waste during phlebotomy procedure. Another key is the application of critical thinking skills during patient assessment and correlating this information with the Hg value to make sound clinical decisions. Blood conservation strategies proposed were the following: consolidate lab test and prevent redundancy, use stop times on serial orders when possible, use pediatric/ small volume tubes for complete blood and platelet counts, draw and waste only the amount of blood required unless, otherwise, merited. Upon review of the evidence of the collaboration, both nurses and physician were supportive of the blood conservation strategies. The impact that innovative blood conservation strategies derived via nurse-physician collaboration and interdisciplinary teamwork should be shared with the healthcare community.