Study on Patient Blood Management in Haematological Patients

The investigators noticed a variable prescription of blood components to haematological patients in the hospital. This study will analyze the prescription and administration of blood components to Haematological patients (pre measurement). Based on these results guidelines on transfusion triggers will be updated and educated to the physicians and new ICT (information and communications technology) implementations will be added to the electronic order for blood components. The investigators hope to see afterwards (post measurement) a more stable prescription and administration of blood components and a more economic use of blood components.

Study Overview

• Status: Suspended
• Conditions: Blood Transfusion; Haematology
• Intervention / Treatment: Other: education of guidelines

Detailed Description

This study is set up as a first step of implementing patient blood management (PBM) in this hospital. PBM is an evidence-based, multidisciplinary approach to optimizing the care of patients who might need transfusion. Not only in pre/per/postoperative setting but also in haematology PBM guidelines can be implemented. Examples are: use of a restrictive haemoglobin trigger for red blood cells (RBC) transfusion, single use policy for the administration of RBC and platelets, administration only for correct indications (including the introduction of an electronic clinical decision support system for ordering blood components), ...

• Study Type: Interventional
• Enrollment (Anticipated): 700
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Belgium
  • Leuven, Belgium, 3000
    • University Hospitals Leuven

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• all adult patients hospitalised at the haematology wards of the University Hospitals of Leuven (UZ Leuven) between 01/08/2017 and 31/07/2018 (pre measurement) and between between 01/08/2019 and 31/07/2020 (post measurement)

Exclusion Criteria:

• ambulatory patients
• patients without blood transfusion administered in their hospitalised period
• patients with no haematological illness that were hospitalised at the haematological wards

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Other: all haematologists; There will be only one arm: the haematologists will all be included in the interventional phase. Interventions are: 1) rewriting guidelines to order blood components; 2) to show the last hemoglobin value on the orders for erytrocytes and the last platelet count on the orders dor thrombocytes and 3)implementation of a clinical decision support system in the electronic rodering of blood components to stimulate restrictive blood transfusion.

Other: education of guidelines; Guidelines will be updated and education will be given to haematologists in several ways.; ICT implementations: a) last result of haemoglobin and platelet count will be shown on the electronic blood order; b) an electronical clinical decision support system will be implemented to order blood components; Other Names: ICT implementations in the electronic patient file

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
how do haematologists prescribe blood components?	The investigators use a questionaire (15-20 questions) to evaluate how haematologists prescribe red blood cells and platelets. Do they analyze the haemoglobin and platelet count before and after each blood transfusion? Do they apply single unit policy for RBC and platelet transfusions? Which triggers are used for RBC and platelet transfusion? Which guidelines are followed? The investigators will send this questionnaire to all haematologists (including haematologists in training) in 2017 (premeasurement) and in 2019-2020 (postmeasurement). The investigators will also use data (which is already available in the patient files) about blood transfusion to evaluate the ordering and administration of blood components during 1 year. For which indication is blood ordered? Is the Haemoglobin level known before the order is send to the blood bank?	up to 1 year pre measurement and up to 1 year post measurement

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
what's the effect of the interventional phase?	The investigators will again use data (which is already available in the patient files) about blood transfusion to evaluate the ordering and administration of blood components during 1 year after the intervention phase. For which indication is blood ordered? Is the Haemoglobin level known before the order is send to the blood bank? Did the interventions lead to less prescriptions/administrations of blood components and more single unit transfusion? We will use SPSS for statistical analysis (frequencies, percentages and means, scatter plots)	up to 1 year (post measurement)

Collaborators and Investigators

• Sponsor: Universitaire Ziekenhuizen KU Leuven
• Investigators: Principal Investigator: Els Costermans, MD, advanced clinical nurse specialist

Study record dates

Study Major Dates

• Study Start (Actual): August 1, 2017
• Primary Completion (Anticipated): September 30, 2021
• Study Completion (Anticipated): September 30, 2021

Study Registration Dates

• First Submitted: July 5, 2017
• First Submitted That Met QC Criteria: July 11, 2017
• First Posted (Actual): July 14, 2017

Study Record Updates

• Last Update Posted (Actual): February 18, 2019
• Last Update Submitted That Met QC Criteria: February 14, 2019
• Last Verified: February 1, 2019

More Information

Terms related to this study

• Keywords: patient blood management; restrictive transfusion
• Other Study ID Numbers: S60580

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No