Infrastructure for monitoring blood transfusion practice in New South Wales hospitals

Objectives: To determine the existing infrastructure for monitoring blood transfusion practices in New South Wales hospitals. Design: A questionnaire survey conducted in August 1998. Participants: All healthcare facilities known to have used blood products from the Australian Red Cross Blood Service - New South Wales in the 12 months before the survey. Main outcome measures: Existence of a transfusion committee and policies and procedures to ensure appropriate use and issue of blood products; monitoring expiry rates of red blood cells, platelets and fresh frozen plasma; using a maximum blood ordering schedule (MBOS); and measuring the crossmatch to transfusion ratio (CT ratio). Results: 224 hospitals were surveyed and 144 responses were received (64%). Twenty-five hospitals (17%) had a transfusion committee; 60 (42%) monitored expiry rates of red cells, and 39 (27%) and 42 (29%), respectively, monitored these rates for platelets and fresh frozen plasma. Thirty-three hospitals (23%) used an MBOS and 43 (30%) measured the CT ratio. However, over 70% of the larger hospitals (>200 beds) had all these aspects of transfusion infrastructure in place, and 35% had transfusion committees. Conclusions: Our survey showed that, overall, there was a lack of transfusion infrastructure in NSW hospitals. However, most of the hospitals with more than 200 beds had infrastructure in place to monitor transfusion practices, but only a minority had established transfusion committees.