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dc.contributor.authorChen, Qiudongen_US
dc.date.accessioned2016-02-10T19:54:56Z
dc.date.available2016-02-10T19:54:56Z
dc.date.issued2014
dc.identifier.urihttps://hdl.handle.net/2144/14369
dc.description.abstractRed blood cells are a scarce resource whose demand often exceeds its supply. Intraoperative red cell salvage has proven to be a highly effective blood conservation strategy, as it can reduce the need for allogeneic blood transfusion. However, the use of cell saver alone is not sufficient. Without specific blood ordering guidelines, the amount of allogeneic blood product requested and cross&ndash;matched is often much greater than the real level of consumption. Efficient blood ordering guidelines have been developed in the past, and have succeeded in providing a more accurate prediction of actual need for intraoperative blood transfusion and minimizing waste. Few studies attempted to examine the blood ordering and utilization pattern with an emphasis on surgical cases that involve the use of intraoperative cell salvage. With the use of intraoperative cell salvage devices to reduce the amount of blood bank products required during surgery, considerable change in the practice of ordering cross&ndash;matched blood should be made. We retrospectively assessed the effectiveness of one Standardized Clinical Assessment and Management Plan (SCAMP) in improving the efficiency of blood utilization and reducing waste. This SCAMP was introduced at our Boston Children's Hospital in July 2012 as a blood ordering guideline for all pediatric orthopedic patients who are scheduled for intraoperative cell salvage. We retrospectively compared demographic variables, clinical characteristics, and blood utilization patterns of patients who underwent orthopedic procedure and received cell saver blood during the 17 months prior to the introduction of SCAMP (n = 455) and those who underwent similar procedures during the 15 months after the introduction of SCAMP (n = 487). Results suggested that demographic variables including age, weight, and sex were similar between the pre&ndash;SCAMP and post&ndash;SCAMP groups. It also demonstrated that after the introduction of SCAMP, the mean percentage utilization of blood (number of units used/number of units ordered x 100%) increased by 24.4% (p < 0.001), while the difference between the number of units ordered and number of units used reduced by 0.5 units (p < 0.001). In conclusion, the introduction of a SCAMP for blood product ordering has led to an increase in the efficiency of blood utilization and a reduction in blood waste. However, further evaluation and modification of the SCAMP need to be made in order to better predict actual level of utilization of blood products.en_US
dc.language.isoen_US
dc.subjectMedicineen_US
dc.subjectBlood transfusionen_US
dc.subjectIntraoperative cell salvageen_US
dc.subjectPediatric orthopedic surgeryen_US
dc.subjectStandardized Clinical Assessment and Management Plan (SCAMP)en_US
dc.titlePatterns of blood product ordering and utilization for surgical pediatric patients scheduled for intraoperative cell salvageen_US
dc.typeThesis/Dissertationen_US
dc.date.updated2016-01-22T18:56:34Z
etd.degree.nameMaster of Scienceen_US
etd.degree.levelmastersen_US
etd.degree.disciplineMedical Sciencesen_US
etd.degree.grantorBoston Universityen_US


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