Decreasing premedication for blood transfusions: A quality improvement project Journal Article


Authors: Hole, A.; Budhai, A.; King, K.; Dayand Borge, P. Jr
Article Title: Decreasing premedication for blood transfusions: A quality improvement project
Abstract: Background:Premedication administration to patients who are to receive blood transfusions continues despite evidence of a lack of benefit when given to prevent febrile nonhemolytic or mild allergic transfusion reactions. Reviews of ordering practices and staff surveys on an adult inpatient hematology-oncology unit in our multisite oncology medical center indicated a lack of standardization and overuse of premedication in blood transfusions and a lack of knowledge of when it was appropriate to use premedication.Methods:A literature search was performed, and the evidence led to a proposal for a quality improvement (QI) project focused on development of an evidence-based algorithm to guide clinicians in when to administer which premedication, development of clear documentation for premedication plans, integration of the documented premedication plans into electronic orders for blood products, and staff education. Interventions included a hospital-wide algorithm and an electronic order to be integrated with a premedication plan for each patient on the adult hematology-oncology unit.Results:Seven months after implementation of the intervention, premedication use among patients decreased by 57.6%, and the transfusion reaction rate decreased from 1% to 0.8%. Staff knowledge as measured by responses to pre- and postintervention surveys on the appropriate use of premedication also improved.Conclusion:Evidence-based interventions can reduce the incidence of premedication use in patients receiving blood transfusions. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Keywords: adult; algorithms; blood transfusion reaction; algorithm; total quality management; blood transfusion; prevention and control; quality improvement; premedication; procedures; humans; human; transfusion reaction; febrile nonhemolytic transfusion reaction
Journal Title: American Journal of Nursing
Volume: 124
Issue: 8
ISSN: 0002-936X
Publisher: Lippincott Williams & Wilkins  
Date Published: 2024-08-01
Start Page: 34
End Page: 41
Language: English
DOI: 10.1097/01.NAJ.0001027116.67274.e3
PUBMED: 38984855
PROVIDER: scopus
DOI/URL:
Notes: Source: Scopus
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MSK Authors
  1. Ashley Hole
    12 Hole
  2. Kerry Rose King
    7 King
  3. Alexandra Budhai
    10 Budhai
  4. Prabhakar Dayanand Borge
    14 Borge