The National Institute for Health and Care Excellence (NICE) has issued its first guideline on the use of transfusions in adults, children and young people to ensure they are used only when necessary.
National audits on the use of blood in England have consistently shown that a fifth or more of transfusions are unnecessary. The guideline gives clear recommendations on when a transfusion should be used for a patient and when alternatives should be considered.
The guideline also includes recommendations to help hospitals provide better care for patients by reducing the need for transfusions wherever possible. This includes encouraging clinicians to prescribe tranexamic acid which can be given to patients undergoing surgery to stop them losing too much blood. Tranexamic acid costs as little as 60 pence and can save hospitals
hundreds of pounds per patient.
The guideline also calls for hospitals to consider using a system that electronically identifies patients to make the transfusion process safer and more efficient. Electronic patient identification systems prompt staff to carry out key steps in the correct order, and ensure that transfusions are given to the right patients through scanning of barcodes on patient wristbands and blood component containers.
Professor Mike Murphy, consultant haematologist at Oxford University Hospitals and chair of the committee that developed the guideline said: “Electronic systems make it easy for staff to do the right thing every time, and avoid errors. They can also provide ‘decision support’ for doctors when they are ordering blood and promote the restrictive use of blood. The guideline also importantly highlights the benefits of the routine use of tranexamic acid in patients undergoing surgery. Routine implementation of these measures in the NHS will make best use of a valuable resource, be safer for patients and save money for hospitals.”
The guidance is available at www.nice.org.uk/guidance/ng24
