PF815 IMPROVING QUALITY IN TRANSFUSION: GAIN LIFE OPTIMIZE RESOURCES
Authors: MARTÍNEZ R. MARTOS , PLATERO M. YUSTE , ARIAS E. GONZALEZ , MARTINEZ L. BERMEJO , ALVAREZ P. BELTRAN , MARTINEZ A. PASCUAL , SILLERO P. LLAMAS 
Published: June 2019

Background:

Blood is a scarce resource that depends on the altruistic character of donors, without being able to be artificially generated.In recent years the needs have grown exponentially,especially in hematological patients,who due to the evolution of their disease need periodic transfusions,causing a deterioration in their quality of life, personal and family, as well as a growing consumption of health resources

Aims:

Main objective: to modify the usual protocol of transfusion of 2 concentrates of hematies (CH) to 1CH,in hematological patients,analyzing the improvement of the perceived quality of life.

Secondary objectives:to analyze the clinical stability (number of weeks without transfusion), the analytical stability and the improvement of the adverse effects of polytransfusion(iron overload,complications in venous access),savings in the number of CH used and adequate management of health resources and health expenses

Methods:

Prospective study in Apr‐Dec/2018 in hematological patients according to inclusion/exclusion criteria. We analyzed demographic parameters(age/sex),main diagnosis(WHO/2016 classification) and clinical stability parameters: hemoglobin/hematocrit and ferrokinetic pattern,number of procedures performed,CH transfused and time (weeks) between transfusions.

The quality of life was collected through anamnesis, analyzing the shorter time of hospital stay during transfusion, satisfaction and perception about the lower family burden through validated quality of life surveys.We record the reduction of the number of CH monthly and compare globally with data from 2017.

Results:

Evaluated 203visits (n = 52 patients). For quality of life and humanization: 98% reported in the anamnesis, a high degree of satisfaction with shorter hospital stay during the transfusion and the time gain for their activities, the data compiled by the NPS (net score of the promoter), highlighting a 97% satisfaction with the time gained for his family, recommending this practice to patients with similar pathologies in 100% of cases.

Clinical response: 95% who have received only 1CH have remained stable,without complications or clinical worsening.The number of weeks between transfusions remained stable compared to the historical cutoff of 2017 with patients with the same clinical and epidemiological characteristics.Reduction of CH employees was 30% in hematology (compared to 2017),which implies an economic and health resources reduction very important.In relation to analytical parameters, only 4 patients presented hemoglobin inestability (transfusion had to be advanced).No patient presented complications with venous accesses and in none was documented iron overload (in comparison with 15% of cases registered in 2017).The reduction of the number of CH employed in the months of study can be seen in figure1.

Summary/Conclusion:

The reduction of CH improves the concept of quality of life perceived by the patient,without this implying a clinical or analytical deterioration,facilitating the basic ethical principle of not doing/not harming this very susceptible group.It also generates cost savings, an efficient measure,which will allow resources to be allocated to the development of new projects that improve the quality of care,life and patient satisfaction

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In the coming months we will extend the project to the rest of the medical specialties that perform more blood transfusions(oncology, intensive care, surgery),introducing unified and validated quality of life scales,which will allow to compare qualitative and subjective data between different services and hospitals and that will reinforce these results.