Patient Blood Management
What is Patient Blood Management (PBM)?
Blood transfusions are the most common procedure performed during
hospitalizations and undoubtedly help patients. However, there are
many scenarios where the risks outweigh the benefits. Studies over
essentially the past 2 decades have found that liberal transfusions
practices make patients more susceptible to infections and increase the
risk of poor outcomes such as longer hospital stays and even death. In
clear absence of benefit, the patient is only exposed to potential risk
and harm.
Patient Blood Management (PBM) is a nationwide, multi-disciplinary
patient safety initiative designed to promote safe, optimal and
efficient use of blood components and blood related resources. PBM
uses evidenced based medical and surgical strategies to reduce or
eliminate all together the need for a blood transfusion.
Why is PBM important?
- Improves patient safety and outcomes by reducing patients' exposure to unnecessary blood transfusions
- Blood transfusions are not as safe as we thought. Literature
clearly supports an association between blood transfusions and
increased patient risks including infections, cancer reoccurrence,
mortality, prolonged hospital stays, and readmissions.
- Reduces unwanted hospital and patient costs
- Conserves a precious resources for those who truly need it.
PBM highlights at UTMB Health include:
- Raising and sustaining awareness about evidence-based transfusion
medicine and the need to adopt conservative transfusion practices
- Revision of the UTMB Transfusion Guidelines to reflect
current evidence. The Transfusion Committee generally supports the
transfusion of red cells at a hemoglobin trigger of 7g/dL, when
clinically indicated.
- Optimizing pre-operative anemia to reduce the likelihood of blood transfusion
- Hard-wiring blood ordering processes for non-bleeding
patients to promote single unit orders and clinical reassessment prior
to ordering additional units
- Reviews of red blood cell orders by Blood Bank physicians to
promote collegial discussion and education of appropriate indication and
dose
- Authorizing nurses to initiate a transfusion reaction investigation work-up without delay
- Providing a forum to plan for the implementation of barcoding
technology for both pre-transfusion specimen collection and blood
administration to reduce the risk of mistransfusion
Frequently Asked Questions