Evaluation of the clinical blood transfusion practice at a tertiary Hospital in Kenya

Abstract

Background: Blood transfusion is an essential component of modern health care. It can restore normal life expectancy and improve quality of life when used appropriately. Adequate blood supply and good clinical practice, which includes appropriate blood use, ensures safe and effective transfusion practice. One of the ways of achieving appropriate blood transfusion is use of blood transfusion guidelines. Objective: To determine the appropriateness and the associated factors of the clinical indication of blood transfusion at a tertiary hospital. Methodology: 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 and data was collected using a data collection form. Data analysis was done using SPSS software version 20. Descriptive statistics, ANOVA, Chi-square and logistic regression were used to analyze the data. A p-value of <0.05 was deemed statistically significant. Results: 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 patients. The proportion of inappropriate transfusion was 49% and the associated factors were pre transfusion hemoglobin (p < 0.001), clinical department (p=0.043), presenting condition (p= 0.010) and the cadre of the prescribing clinician (p=0.008). Conclusion: The proportion of patients who had inappropriate blood transfusion was 49% implying that the adherence to the recommended national guidelines was unsatisfactory.