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