Research conducted over the past few decades has shed light on the risks of blood transfusions. Patient blood management utilizes multidisciplinary and multimodality measures to decrease the need for blood transfusions to achieve the best outcomes.
by Caitlin Lorincz, MA, MS
Do you know who Dr. Arlie Bock was? A Harvard Medical School researcher and a pioneer in the field of blood research, Dr. Bock cautioned his peers about the use of blood transfusions—back in 1936! Writing in the New England Journal of Medicine, he argued, “transfusion of blood may be a life-saving procedure under certain circumstances, it may be a necessary supportive measure under others, but it is too often undertaken when . . . all other therapy has failed.”
Blood transfusion has been a standard of medical practice for decades, but nearly 80 years after Dr. Bock’s warning, the safety and efficacy of blood
Research findings suggest
that more restrictive transfusion strategies are safe for most
transfusions remains a challenge. In fact, research conducted over the past few decades has shed light on the risks of blood transfusions, with findings suggesting that more restrictive transfusion strategies are safe for most patient populations.
So how do we achieve safer use of blood and blood products?
Patient blood management, or PBM, is defined as “the scientific use of safe and effective medical and surgical techniques designed to minimize and manage anemia and decrease bleeding in an effort to improve patient outcomes.” The practice involves multidisciplinary and multimodality preventive measures to decrease the need for blood transfusions by focusing on four key areas:
- Managing anemia
- Optimizing coagulation status
- Using interdisciplinary blood conservation modalities
- Encouraging patient-centered decision making
By addressing these areas, clinicians can select the treatment that is most likely to provide greater benefit than risk and is more likely to bring the best outcome to the patient.
The cornerstones of a successful patient blood management (PBM) program are the implementation of evidence-based transfusion guidelines to reduce variability in transfusion practice, staff education, and implementation of a variety of clinical strategies.
PBM strategies can be implemented at every stage of care for both surgical and nonsurgical patients. Yet it is critical that health systems provide physician and nurse education when implementing a PBM program. Having a multidisciplinary team involved in the development and implementation of a PBM program is really essential.
In an effort to address the need for education in this area, the National Patient Safety Foundation recently released an online educational module, Patient Blood Management through the Lens of Patient Safety. Developed by a distinguished panel of experts in the field and rigorously reviewed by a separate independent panel, the module consists of a monograph and five video lectures, enabling learners to review the material at their own pace.
“This is an area where we have good research to show us what to do, we just need to get the teams together and educate people about these best practices,” says Tejal K. Gandhi, MD, MPH, CPPS, president and CEO of NPSF. “If we can get clinicians to embrace these PBM strategies, we can help make care safer for patients.”
Haemonetics, an international company specializing in products and services related to blood management, provided an educational grant to support the development of Patient Blood Management through the Lens of Patient Safety.
“We were very pleased to be able to support NPSF in the development of this educational program,” said Byron Selman, president, Global Markets, Haemonetics. “At Haemonetics, we strongly believe in the safe and efficient use of blood products, and we believe the work that NPSF has produced will prove very helpful to those working across the continuum of health care.”
On October 21, from 4:00 to 5:00 pm Eastern Time, NPSF is offering a webcast on this topic featuring members of the expert panel that developed the content. This webcast is being offered free of charge, thanks to underwriting from Haemonetics, but registration is required. Registration will open soon. Visit the web page.
Back to top
Do you have a PBM program at your organization? Comment on this post below. Note: to post a comment you must be logged in. Register or log in.
About the Author: Caitlin Lorincz, MA, MS is senior director, programs, at the National Patient Safety Foundation and a contributing author of Patient Blood Management through the Lens of Patient Safety. Contact her at firstname.lastname@example.org.