Blood management: Best-practice transfusion strategies
Deborah J. Tolich MSN, RN
Sheila Blackmur MSN, RN
Ken Stahorsky MBA, RN
Danita Wabeke BA, RN

January 2013 
Volume 43  Number 1
Pages 40 - 47
  PDF Version Available!

BLOOD TRANSFUSIONS to treat anemia can have a significant impact on patient outcomes. Because transfusion practices vary among healthcare providers, many clinicians question the best practice for blood product use. Blood management is defined as a patient-centered standard of care in which strategies and techniques are used to reduce, eliminate, or optimize blood transfusions to improve patient outcomes.1 Blood management programs have addressed the variances in healthcare provider practice as they've reduced blood use and healthcare costs.This article reviews the evidence and experience gained from formal blood management programs. It identifies and discusses these three areas of blood management: methodology, implementation, and nurses' direct-care practice.Anemia isn't a disease but a sign of an underlying illness or condition. Anemia falls into three major categories: nutritional deficiency, acute or chronic blood loss, and anemia of chronic disease. All three contribute to a limited number of red blood cells (RBCs) carrying oxygen to organs and tissues, resulting in signs and symptoms that may cause decreased physical performance.1 (For more information, see What's anemia?)If evidence shows that reducing allogeneic (donor blood) transfusions improves patient outcomes while decreasing costs, how should nurses translate this evidence into their practice? Current research about advanced anemia management, cost accountability, and the negative consequences of allogeneic blood transfusions continue to influence nursing practice. With today's limited supply of blood products and increasing costs associated with transfusions, it's prudent for healthcare institutions to advance their standard of care by adopting blood management practices.Many underestimate the true cost of blood. According to a recent analysis, the cost of a unit of RBCs is between $522 and $1,183.2 Nurses and healthcare providers have a responsibility to exercise good stewardship and take measures to

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