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Documentation of the Clinical Blood Transfusion Practice at a Teaching and Referral Hospital in Western Kenya

Received: 12 December 2018    Accepted: 22 January 2019    Published: 15 February 2019
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Abstract

Blood transfusion is an essential component of modern health care. It can restore normal life expectancy and improve quality of life when used safely. Blood is scarce, costly and its use could be associated. with complications. Good clinical practice, which includes proper documentation, ensures safe and effective transfusion practice. The objective of the study was to analyze the process of documenting the clinical blood transfusion practice at public teaching and referral hospital. A hospital based medical chart review of 384 patients who were transfused from June 2013 to November 2013 was carried out. Systematic random sampling method was used to sample the patient medical charts and a data was collected using a structured data collection. Data was analyzed using frequency tables and is presented in form of text, tables and charts. Approval was obtained from Institutional Research and Ethical Committee of Moi University and the patient’s medical records were de-identified. The median age of the recipients was 31.5 years (IQR 13, 45.8) and the range was 1 day to 89 years. Females comprised 55.2% of the recipients. The indication of the transfusion, pre-transfusion Hb, consent, blood and blood product unit number, start times, duration of transfusion and observations of vital signs were documented in the charts of 91.1%. 99.0%, 0.8%, 73.4%, 43%, 47.1% and 27.6% of all the recipients respectively. It was concluded that there were inadequacies in the documentation of the transfusion process. The strategies of clinical audit and continuing medical education of health workers ought to be applied in order to improve the documentation of the clinical practice of blood transfusion. In addition, studies to establish the reasons for inadequate documentation of the transfusion process should be carried out.

Published in American Journal of Health Research (Volume 7, Issue 1)
DOI 10.11648/j.ajhr.20190701.12
Page(s) 8-11
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Documentation, Blood Transfusion Practice, Transfusion Process

References
[1] World Health Organization. Universal Access to Blood Transfusion [Internet]. Geneva. WHO; [cited 2013 May 4]. Available from: http://www.who.int/bloodsafety/publications/Universal Accessto Safe BT. Pdf.
[2] Murphy MF, Stanworth SJ, Yazer M. Transfusion practice and safety: current status and possibilities for improvement. Vox Sang. 2011 Jan; 100 (1): 46–59.
[3] Nursing and Midwifery Council. Record Keeping: Guidance for Nurses and Midwives [Internet]. NMC; [cited 2017 Jul 25]. Available from: www.nipec.n-i.nhs.uk//nmcGuidance Record Keeping Guidancefor Nursesand Midwive.
[4] Frank-Stromborg M, Christensen A, Elmhurst D. Nurse documentation: not done or worse, done the wrong way--Part I. Oncol Nurs Forum. 2001 May; 28 (4): 697–702.
[5] Audet AM, Goodnough LT, Parvin CA. Evaluating the appropriateness of red blood cell transfusions: the limitations of retrospective medical record reviews. Int J Qual Health Care. 1996 Feb; 8 (1): 41–9.
[6] De Graaf JD, Kajja I, Bimenya GS, Postma MJ, Sibinga CT. Bedside practice of blood transfusion in a large teaching hospital in Uganda: An observational study. Asian J Transfus Sci. 2009 Jul; 3 (2): 60–5.
[7] Natukunda B, Schonewille H, Smit Sibinga CT. Assessment of the clinical transfusion practice at a regional referral hospital in Uganda. Transfus Med. 2010 Jun; 20 (3): 134–9.
[8] Grewal P, Neffendorf J, Williams B. The quality of blood transfusion documentation and consent in surgical patients at a central London teaching hospital. What should we be teaching to maintain good transfusion practice? International Journal of Surgery. 2012 Jan 1; 10 (8): S78.
[9] Dos Reis VN, Paixão IB, Perrone ACA de SJ, Monteiro MI, dos Santos KB. Transfusion monitoring: care practice analysis in a public teaching hospital. Einstein (Sao Paulo). 2016; 14 (1): 41–6.
[10] Fastman BR, Kaplan HS. Errors in transfusion medicine: have we learned our lesson? Mt Sinai J Med. 2011 Dec; 78 (6): 854–64.
[11] Mosha D, Poulsen A, Reyburn H, Kituma E, Mtei F, Bygbjerg IC. Quality of paediatric blood transfusions in two district hospitals in Tanzania: a cross-sectional hospital based study. BMC Pediatr. 2009 Aug 14; 9: 51.
[12] World Health Organization. Global Status Report on Blood Safety and Availability [Internet]. Geneva. WHO; [cited 2017 Jun 10]. Available from: apps.who.int/iris/bitstream/10665/254987/1/9789241565431-eng. pdf.
[13] Merab E, Osota M. State of Kenya’s Blood Banks. Daily Nation. 2015 Jun 17;35–6.
[14] Thomas J, Ayieko P, Ogero M, Gachau S, Makone B, Nyachiro W, et al. Blood Transfusion Delay and Outcome in County Hospitals in Kenya. Am J Trop Med Hyg. 2017 08; 96 (2): 511–7.
[15] Lackritz EM, Campbell CC, Ruebush TK, Hightower AW, Wakube W, Steketee RW, et al. Effect of blood transfusion on survival among children in a Kenyan hospital. Lancet. 1992 Aug 29; 340 (8818): 524–8.
[16] Lackritz EM, Ruebush TK, Zucker JR, Adungosi JE, Were JB, Campbell CC. Blood transfusion practices and blood-banking services in a Kenyan hospital. AIDS. 1993 Jul; 7 (7): 995–9.
[17] Norfok D. Handbook of Transfusion Medicine [Internet]. 5th ed. London: TSO: United Kingdom Book Services; [cited 2018 Nov 27]. Available from: https://www.transfusionguidelines.org//transfusion-handbook/5th % 20 Handbook %20.
[18] Johnson V, Langeberg A, Taye-Makuria A, Sandler SG. Temperature-sensitive labels for containers of RBCs. Am J Clin Pathol. 2006 Sep; 126 (3): 406–10.
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  • APA Style

    Japheth Chebii Kipkulei, Nathan Gyabi Buziba, Simeon Kipkoech Mining. (2019). Documentation of the Clinical Blood Transfusion Practice at a Teaching and Referral Hospital in Western Kenya. American Journal of Health Research, 7(1), 8-11. https://doi.org/10.11648/j.ajhr.20190701.12

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    ACS Style

    Japheth Chebii Kipkulei; Nathan Gyabi Buziba; Simeon Kipkoech Mining. Documentation of the Clinical Blood Transfusion Practice at a Teaching and Referral Hospital in Western Kenya. Am. J. Health Res. 2019, 7(1), 8-11. doi: 10.11648/j.ajhr.20190701.12

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    AMA Style

    Japheth Chebii Kipkulei, Nathan Gyabi Buziba, Simeon Kipkoech Mining. Documentation of the Clinical Blood Transfusion Practice at a Teaching and Referral Hospital in Western Kenya. Am J Health Res. 2019;7(1):8-11. doi: 10.11648/j.ajhr.20190701.12

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  • @article{10.11648/j.ajhr.20190701.12,
      author = {Japheth Chebii Kipkulei and Nathan Gyabi Buziba and Simeon Kipkoech Mining},
      title = {Documentation of the Clinical Blood Transfusion Practice at a Teaching and Referral Hospital in Western Kenya},
      journal = {American Journal of Health Research},
      volume = {7},
      number = {1},
      pages = {8-11},
      doi = {10.11648/j.ajhr.20190701.12},
      url = {https://doi.org/10.11648/j.ajhr.20190701.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajhr.20190701.12},
      abstract = {Blood transfusion is an essential component of modern health care. It can restore normal life expectancy and improve quality of life when used safely. Blood is scarce, costly and its use could be associated. with complications. Good clinical practice, which includes proper documentation, ensures safe and effective transfusion practice. The objective of the study was to analyze the process of documenting the clinical blood transfusion practice at public teaching and referral hospital. A hospital based medical chart review of 384 patients who were transfused from June 2013 to November 2013 was carried out. Systematic random sampling method was used to sample the patient medical charts and a data was collected using a structured data collection. Data was analyzed using frequency tables and is presented in form of text, tables and charts. Approval was obtained from Institutional Research and Ethical Committee of Moi University and the patient’s medical records were de-identified. The median age of the recipients was 31.5 years (IQR 13, 45.8) and the range was 1 day to 89 years. Females comprised 55.2% of the recipients. The indication of the transfusion, pre-transfusion Hb, consent, blood and blood product unit number, start times, duration of transfusion and observations of vital signs were documented in the charts of 91.1%. 99.0%, 0.8%, 73.4%, 43%, 47.1% and 27.6% of all the recipients respectively. It was concluded that there were inadequacies in the documentation of the transfusion process. The strategies of clinical audit and continuing medical education of health workers ought to be applied in order to improve the documentation of the clinical practice of blood transfusion. In addition, studies to establish the reasons for inadequate documentation of the transfusion process should be carried out.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - Documentation of the Clinical Blood Transfusion Practice at a Teaching and Referral Hospital in Western Kenya
    AU  - Japheth Chebii Kipkulei
    AU  - Nathan Gyabi Buziba
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    JF  - American Journal of Health Research
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    UR  - https://doi.org/10.11648/j.ajhr.20190701.12
    AB  - Blood transfusion is an essential component of modern health care. It can restore normal life expectancy and improve quality of life when used safely. Blood is scarce, costly and its use could be associated. with complications. Good clinical practice, which includes proper documentation, ensures safe and effective transfusion practice. The objective of the study was to analyze the process of documenting the clinical blood transfusion practice at public teaching and referral hospital. A hospital based medical chart review of 384 patients who were transfused from June 2013 to November 2013 was carried out. Systematic random sampling method was used to sample the patient medical charts and a data was collected using a structured data collection. Data was analyzed using frequency tables and is presented in form of text, tables and charts. Approval was obtained from Institutional Research and Ethical Committee of Moi University and the patient’s medical records were de-identified. The median age of the recipients was 31.5 years (IQR 13, 45.8) and the range was 1 day to 89 years. Females comprised 55.2% of the recipients. The indication of the transfusion, pre-transfusion Hb, consent, blood and blood product unit number, start times, duration of transfusion and observations of vital signs were documented in the charts of 91.1%. 99.0%, 0.8%, 73.4%, 43%, 47.1% and 27.6% of all the recipients respectively. It was concluded that there were inadequacies in the documentation of the transfusion process. The strategies of clinical audit and continuing medical education of health workers ought to be applied in order to improve the documentation of the clinical practice of blood transfusion. In addition, studies to establish the reasons for inadequate documentation of the transfusion process should be carried out.
    VL  - 7
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Author Information
  • Department of Haematology and Blood Transfusion, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya

  • Department of Haematology and Blood Transfusion, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya

  • Department of Immunology, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya

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