减少缺铁性贫血(ReBIDA)的输血:一项质量改进倡议。

Q3 Medicine
Advances in Hematology Pub Date : 2025-06-17 eCollection Date: 2025-01-01 DOI:10.1155/ah/5513287
Andrew Picca, David Kling, Amanda Jacobson-Kelly, Kathleen Nicol, Joseph Stanek, Vilmarie Rodriguez
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引用次数: 0

摘要

背景:缺铁性贫血(IDA)是儿童贫血最常见的形式,一线治疗的重点是通过口服和/或静脉补铁。美国血液学学会(ASH)/美国儿科血液学和肿瘤学学会(ASPHO)明智选择运动建议无症状IDA患者不要使用填充红细胞(PRBC)输血。红细胞是一种有限的资源,与铁疗法相比具有治疗相关的风险。口服和静脉注射铁是一种有效的、可耐受的治疗IDA的方式,可根据贫血程度而忽略。研究设计和方法:计划、行动、研究、行动方法学用于这项单一机构质量改进计划。目标是到2022年12月将所有入院IDA患者的PRBC输注百分比从72%的基线降低到50%的目标,并持续12个月。干预措施包括多学科、以证据为基础的教学教育会议和制定单一机构治疗IDA的临床实践指南。结果:在学前教育/基线组中,72% (n = 57/79)的患者接受了PRBC输血治疗IDA,而在教育后/干预组中,38% (n = 29/76)的患者接受了PRBC输血治疗IDA (p值< 0.0001)。在学前教育/基线组中,19% (n = 11/57)的患者接受了基于未开发的CPG的PRBC输注,而在教育后/干预组中,这一比例为6.9% (n = 2/18) (p值= 0.20)。讨论:这项工作证明了多学科、教育和循证干预如何导致住院IDA患者输血PRBC的临床和统计显著减少。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Reduction of Blood Transfusion in Iron Deficiency Anemia (ReBIDA): A Quality Improvement Initiative.

Background: Iron deficiency anemia (IDA) is the most common form of pediatric anemia, with first-line treatment focusing on iron repletion through oral and/or intravenous iron. The American Society of Hematology (ASH)/the American Society of Pediatric Hematology and Oncology (ASPHO) Choosing Wisely Campaign recommends against packed red blood cell (PRBC) transfusion for asymptomatic IDA. PRBCs are a finite resource and carry treatment associated risk compared to iron therapies. The use of oral and intravenous iron is an effective, tolerated therapy modality for IDA which can be overlooked based on the degree of anemia. Study Design and Methods: Plan, Do, Study, Act methodology was used for this single institution quality improvement initiative. The objective was to decrease the percentage of PRBC transfusions in all admitted IDA patients from a baseline of 72% to a target of 50% by December 2022 and to sustain for 12 months. Interventions consisted of multidisciplinary, evidence-based didactic education sessions and development of a single institution clinical practice guideline for the treatment of IDA. Results: In the pre-education/baseline group, 72% (n = 57/79) of patients received PRBC transfusion for the treatment of IDA, compared to the posteducation/intervention group where 38% (n = 29/76) of patients received PRBC transfusion for the treatment of IDA (p value < 0.0001). In the pre-education/baseline group, 19% (n = 11/57) of patients received PRBC transfusions not indicated based on the developed CPG, compared to 6.9% (n = 2/18) in the posteducation/intervention group (p value = 0.20). Discussion: This work demonstrates how multidisciplinary, education- and evidence-based interventions lead to clinically and statistically significant reductions in PRBC transfusion for admitted patients with IDA.

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来源期刊
Advances in Hematology
Advances in Hematology Medicine-Hematology
CiteScore
3.30
自引率
0.00%
发文量
10
审稿时长
15 weeks
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