Sarah M Tweddell, Thomas M Morelli, Timothy M Bahr, Ashley Krueger, Robert D Christensen, Robin K Ohls
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Identifying barriers to complying with new restrictive NICU transfusion guidelines.
Objectives: Our NICU transfusion stewardship group proposed new, more restrictive guidelines for red blood cell and platelet transfusions. To evaluate our clinician's support for these, we conducted a series of structured interviews.
Study design: We presented 11 scenarios involving the new guidelines to each of 24 clinicians. After every scenario we asked whether they would abide by the guideline, and if not, why.
Results: For 88% of scenarios, participants said they supported the guideline and would not transfuse. The most common reasons for wanting to transfuse when the guidelines said not to were; 1) the scenario-patient did not meet the guideline but was "close" and 2) the guideline was insufficiently explicit.
Conclusions: Structured interviews like these can identify barriers to complying with transfusion guidelines and can suggest guideline modifications. Future studies will determine the effect of this discovery process on guideline adherence and patient outcomes.
期刊介绍：
The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development.
The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.
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