Nursing Informatics Transforming Transfusion Management

With the shortage of blood supplies, management of blood products for patients, patient preference and religious beliefs, and patient care outcomes post-blood administration, an alternative source for treating patients requiring transfusion management transformed and improved patient care management with the implementation of a hospital transfusion-free anemia management program for hemoglobin 7.1-9 g/L at University Medical Center of El Paso. The development and implementation of a power plan within the EHR that managed patient care for inpatients as well as the development of an ambulatory care follow-up program guided clinical teams while improving patient care. The underlying purpose of this initiative focused on evaluating and discussing the outcome of the interdisciplinary approach enabling bedside nurses, physicians, pathologists, laboratory specialists, blood bank specialists, pharmacists, nursing informatics, information technology, and other essential healthcare teams to better understand evidence-based practice principles in the management of blood and improving patient care.

Variability in blood management guidelines to include nurse and physician understanding of the importance of utilizing the hospital transfusion-free anemia management program power plan was observed with the use of data from the EHR identifying a need to review criteria and focus on engagement with utilization of the power plan. An interdisciplinary subcommittee was formed composed of bedside nurses and administrators, residents and physicians, and nursing informatics to outline the principles and criteria outlined in the power plan and increase engagement with the utilization of the power plan and bring uniformity with treating patients with transfusion-free anemia criteria.

Strategy and implementation included the use of PDSA and the principles of Kolb's model of experiential learning. The combination of handouts, badge buddies, power point presentations at nursing leadership committee meetings, and physician medical staff process improvement meetings to include education specific to the use of the hospital transfusion-free anemia management program power plan improved the utilization of the power plan.

Results revealed significant positive changes with the utilization of the power plan. There was also improvement in the number of patients referred to the outpatient anemia management program upon discharge.

The transfusion-free anemia management program serves as a model to other healthcare organizations that would like to implement a transfusion-free management program with the use of an electronic power plan in the midst of blood shortages and complex treatment plans for patients requiring transfusions. It assists in enhancing the knowledge base and confidence of nurses and physicians interested in evidence based practice that improve patient care. The transfusion-free anemia management program went from 20% to 90% utilization and continues to grow.