RTC DATABASE April 2014 March 2015 Dedicated Tx Sessions HTC - - PowerPoint PPT Presentation

RTC DATABASE

April 2014 – March 2015

Dedicated Tx Sessions

• HTC Chair – 7 shared sessions with the role
• f CH responsible for Tx
• TLM – range between 1-10, with 2/3rds 10
• TP – range between 1-15
• CH for Tx – 4 with no sessions

HTC Attendance By Specialty

2 2 7 6 1 Emergency Department 9 5 4 Orthopaedics 9 3 3 3 Clinical Governance 5 6 6 1 Surgery 3 5 8 2 Obs & Gynae 2 1 5 10 Anaesthetics 4 14 Haematology 7 5 5 1 Medicine (excl. Haematology) NA Never Sometimes Frequently Always

Make Transfusion Safer

Induction Training (18 hospitals provided data)

Induction Training

1 3 5 7 9 11 13 15 17 19 M e d i c a l T r a i n e e M e d i c a l P e r m a n e n t N u r s e s H C A P h l e b

• t
• m

i s t s T h e a t r e N u r s e s / O D P P

• r

t e r s

• No. of Hospitals

Yes Gave % Trained >75% Trained

Regular Training (18 hospitals provided data)

Regular Training

1 3 5 7 9 11 13 15 17 19 M e d i c a l T r a i n e e M e d i c a l P e r m a n e n t N u r s e s H C A P h l e b

• t
• m

i s t s T h e a t r e N u r s e s / O D P P

• r

t e r s

• No. of Hospitals

Yes Gave % Trained >75% Trained

LIMS System Supports Electronic Dispatch Note

<300 300-800 >800 Yes 2 6 1 No 1 6 2 If Yes, do you use EDN Yes 1 5 1 No 1 1

Electronic / Radiofrequency technology throughout tx process

<300 300-800 >800 Full / Part Full / Part Full / Part Yes 1 / 1 5 / 5 0 / 1 No 1 2 2

Laboratory Information

All CPA and NEQAS compliant 10 not yet UKAS accredited

Electronic Issue

2011 81% (17 out of 21) 2012 79% (15 out of 19) 2013 79% (15 out of 19) 2014 84% (16 out of 19) 2015 89% (16 out of 18)

Electronic Pathology Requesting

Group & Save 28% ( 5 out of 18) Crossmatch 17% ( 3 out of 18)

Request for Transfusion where indication unclear usually challenged

Requests Challenged by Staff

1 2 3 4 5 6 7 8 9 <300 300-800 >800

• No. of Hospitals

Yes No

RBC Issues

2000 4000 6000 8000 10000 12000 14000 16000 18000 20000 D e r r i f

• r

d U H B R D & E S

• u

t h m e a d R U H B a t h R C H T a u n t

• n

G W H G l

• u

c . R B C H T

• r

b a y C h e l t . P

• l

e S a l i s b u r y D

• r

s e t B a r n s t a p l e W e s t

• n

Y e

• v

i l N u f f . C h e l t . S p i r e B r i s t

• l

N u f f . E x e t e r 2004/200 5 2005/200 6 2006/200 7 2007/200 8 2008/200 9 2009/201 2010/201 1 2011/201 2 2012/201 3 2013/201 4 2014/201 5

Platelet Issues

500 1000 1500 2000 2500 3000 3500 4000 4500 5000 UHB Derriford RBCH RCH RD&E RUH Bath Chelt. Poole Southmead Taunton GWH Dorset Salisbury Glouc. Torbay Weston Barnstaple Yeovil Spire Bristol

• Nuff. Exeter
• Nuff. Chelt.

2004/200 5 2005/200 6 2006/200 7 2007/200 8 2008/200 9 2009/201 2010/201 1 2011/201 2 2012/201 3 2013/201 4 2014/201 5

General Patient Blood Management

Yes No NG Depts use EPO as alternative to tx 11 7 Trust has tx triggers 15 3 0 Are these in line with NBTC Codes 14 1 Guidelines incorporate Single unit use 15 3

Surgical Patient Blood Management

7/16 10/11 0/3 1/5 Specific Departments 2/18 7/18 15/18 13/18 Trustwide Measurement of clotting parameters Identification

• f Hb

Provide Information Leaflets Identify & Treat Anaemia Provide Point of Care Testing Pre-Operative Assessment

Cell Salvage

22% 67% 83%

2015

58% 63% 68%

2013

58% 58% 74%

2014

68% 63% 79%

2012

71% 52% 71%

2011

53% 55% 75% 63% Out of Hours Use Post Operative Cell Salvage Provide Intra Operative Cell Salvage 74% 79%

2010

65% 80%

2008

82% 68%

2009

71% 71%

2007

During Routine working Hours

Is tranexamic Acid used: YES: 16 NO: 2

Medical Patient Blood Management

2/4 6/10 Specific Departments 14/18 8/18 Trustwide Provide Information Leaflets Identify & Treat Anaemia

Use of rFVIIa

1 2 12 2 10 13 2007 1 3 11 2 1 9 14 2008 2 2 11 1 11 14 2009 1 12 2 7 14 2010 12 3 1 6 13 2011 1 12 2 1 6 13 2012 1 10 1 1 7 12 2013 1

• 9

1 1 10 13 2014 1 >10

• 6-10

10 1-5 Non- Haemophilia 2 >10 1 6-10 9 1-5 Haemophilia 13 Hospital Stocks 2015 PCC - all NHS + 1 private hospital stocks and none said did not use

Obstetric Practice (NHS Hospitals Only)

15 NHS hospitals gave a Single Dose 28 – 30 weeks 1 did not answer % Issued Traceable to Named Patient

• 9 -100%
• 6 - > 95%
• 1 - >90%

15 hospitals had a Strategy/Policy to identify and treat maternal anaemia

Summary

• Participation all but one NHS & 2 private hospitals
• Structure –
• All hospitals have HTT
• In 4 NHS hospitals CH has no dedicated sessions
• No HTC attendance – anaesthetics, surgery, orthopaedics, CG plus NHS

hospitals medicine & ED

• Regular training – only 6 achieve >75% for permanent medical

staff

• Electronic -issue ~90%, requesting <30%, full/part blood

tracking >70%, EDN 50%

• RBC annual issues 2.9%, platelet issues 4.7%
• PBM – 3 no strategy to use single unit RBC’s
• PBM surgical – some hospitals no pre-op anaemia

management, leaflets or TXA use. IOCS , post op CS