전자 처방 시스템의 간단한 개선을 통한 적합한 혈액제제 활용 증대 (Impact of Electronic Prescription System Modification for Appropriate Blood Component Utilization)

서지정보

· 발행기관 : 대한수혈학회
· 수록지 정보 : 대한수혈학회지 / 35권 / 3호 / 178 ~ 186페이지
· 저자명 : 박수응, 이진경, 홍영준, 오애진, 김혜진

초록

Background: Transfusion reactions have been under-reported, and the laboratory tests to evaluate the causes of the reactions are unfamiliar to physicians other than transfusion specialists. The paper-based transfusion reaction reporting system previously used in our hospital was one-way, with physicians submitting it to the Department of Transfusion Management. To address this, we developed an electronic reporting system that improves commu nication with physicians to identify the cause of transfusion reactions and recommend appropriate blood components.
Methods: To assess the status of transfusion reaction reporting, transfusion reaction reports and transfusion nursing records of 5 years from 2019 to 2023 were analyzed. The transfusion reaction reporting system comprises two parts: the physician's report and the response from the Department of Transfusion Management. If physicians order blood products for patients with a history of prior transfusion reactions, a pop-up alert appears, warning them to check the details of the previous report.
Results: From 2019 to 2023, 2.5% cases of transfusion-related symptoms occurred annually and only 2.6% of transfusion reactions were reported. In 21 out of the 31 cases, the cause was difficult to determine due to inadequate laboratory tests.
The attending physicians of 12 cases were given a recommendation to use blood products or to conduct further laboratory tests by the Department of Transfusion Management to reduce recurrence, but the advice was followed only in 4 cases.
Conclusion: The electronic transfusion reaction reporting system could help physicians conduct appropriate investigations for transfusion reactions and inform physicians regarding the laboratory tests required to be undertaken. It is expected to enhance blood transfusion safety and management by improving communication with physicians. (Korean J Blood Transfus 2024;35:187-195)

영어초록

Background: Transfusion reactions are major considerations in transfusions. Appropriate transfusion practices are essential to minimize the risk of transfusion reactions, such as using irradiated and leukoreduced blood components for indicated patients. This study examined the effectiveness of an electronic prescription system modification in promoting the appropriate use of these blood components.
Methods: The blood component prescription data from seven years (Jan 2016∼Dec 2022) were analyzed retrospectively. The proportion of irradiated units was calculated for each half-year. Each transfusion was categorized by cancer diagnosis, blood component type, and visit type. Statistical comparisons were performed to assess the changes in the use of irradiated blood units and leukoreduced red cell components before and after the system modification.
Results: This study analyzed 33,701 blood component prescriptions. The average number of irradiated units per prescription increased significantly from 0.21 to 0.77 after system modification. All patient groups, excluding transfusion in the operating room, showed a significant increase in irradiated unit use (P≤0.001). In addition, the percentage of leukoreduced red cell components increased significantly after the intervention (P<0.001).
Conclusion: Modification of the electronic prescription system was effective in promoting the appropriate use of irradiated blood components among clinicians. This intervention can reduce transfusion reactions and improve patient outcomes by ensuring the correct selection of blood components for the indicated patients. (Korean J Blood Transfus 2024;35:178-186)

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