Benchmark for transfusion reactions

[John C. Staley]

Does anyone know of any benchmark data concerning transfusion reactions?An example is, in the 3rd quarter this year we had one transfusion reaction for every 177 products transfused. (Nothing significant just hives and non-hemolytic febrile mostly.) Our nursing QA person who this monitors is wondering how our numbers fits in the larger scheme of things.

Thanks

John

[blut]

Hi, John,

About benchmark data for transfusion reactions, I would caution that they are particularly hard to benchmark meaningfully since there are many factors that affect transfusion reaction rate, including

* patient population (particularly the % of multi-transfused patients, who would be expected to have higher rates)

* % of patients transfused with platelets (rates are much higher for this group)

* how rigorous the criteria are that are used to define what consitutes a reaction (facilities that look for them using defined criteria would be expected to have higher rates; different criteria would produce different reaction rates)

* type of product transfused (facilities transfusing ony leukoreduced products may have lower rates)

For rates to be applicable facilites should be relatively closely matched these factors.

Cheers, Pat

[Jane]

Our facility uses 2% and right now we just track those associated with red cell units. I read (either in the technical manual or a textbook) that if you have more than 2% there may be a problem and if you have less there may be under-reporting (or nurses not recognizing a reaction). We have just started tracking this in Blood Utilization and we are fairly close to this number. Sorry that I can't remember the exact reference! If I run across it, I'll pass it along.

[Sandy Smietana]

Hi John,

The Illinois Association of Blood Banks did a benchmarking survey in 1999 and Transfusion Reactions were included as part of the survey results released in 2000. It was very difficult to interpret and compare the survey results with our internal results for the reasons stated in Pat's response.

Our nurses are trained on the reaction criteria, both the blood bank and the patient's physician are notified when a reaction is suspected. We collect our data and present it by type of reaction and products transfused. we then compare our findings against previous years looking for trends. I have data starting in 1996 and our reaction rates are basically the same each year. I've never seen any benchmarking data published except for hemollytic reactions, I'll have to check the Technical Manual and see if I can find the 2% rate. If anyone has any information I would also be interested in benchmark data.

[luhubert]

I'm looking for ways to ensure that nurses notice and document reaction symptoms. We get so few reported, something like .2 of 1 % that I know under-reporting is going on. I've read the 2% somewhere, too, but can't remember where. We present symptoms at a competency fair, have them written in a nursing manual, have them in a "lab manual for nurses" on each floor and give periodic inservices. Other suggestions would be welcome.

[John C. Staley]

Thanks for the responses. You have pretty much confirmed my suspicions.