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Risk factors for inappropriate blood requisition among hospitals in Tanzania

Mauka, Wilhellmuss I. ; Mtuy, Tara B. ; Mahande, Michael J. ; Msuya, Sia E. ; Mboya, Innocent B. LU orcid ; Juma, Abdul and Philemon, Rune N. (2018) In PLoS ONE 13(5). p.1-16
Abstract

Background Blood is a critical aspect of treatment in life saving situations, increasing demand. Blood requisition practices greatly effect sufficient supply in blood banks. This study aimed to determine the risk factors for inappropriate blood requisition in Tanzania. Methods This was a cross sectional study using secondary data of 14,460 patients’ blood requests from 42 transfusion hospitals. Primary data were obtained by using cluster-sampling design. Data were analysed using a two-level mixed-effects Poisson regression to determine fixed-effects of individual-level factors and hospital level factors associated with inappropriate blood requests. P-value <0.05 (2-tails) was considered statistically significant. Results... (More)

Background Blood is a critical aspect of treatment in life saving situations, increasing demand. Blood requisition practices greatly effect sufficient supply in blood banks. This study aimed to determine the risk factors for inappropriate blood requisition in Tanzania. Methods This was a cross sectional study using secondary data of 14,460 patients’ blood requests from 42 transfusion hospitals. Primary data were obtained by using cluster-sampling design. Data were analysed using a two-level mixed-effects Poisson regression to determine fixed-effects of individual-level factors and hospital level factors associated with inappropriate blood requests. P-value <0.05 (2-tails) was considered statistically significant. Results Inappropriate requisition was 28.8%. Factors significantly associated with inappropriate requisition were; reporting pulse rate and capillary refill decrease the risk (RR 0.74; 95% CI 0.64, 0.84) and (RR 0.73; 95% CI 0.63, 0.85) respectively and the following increased the risk; having surgery during hospital stay (RR 1.22; 95% CI 1.06, 1.4); being in general surgical ward (RR 3.3; 95% CI 2.7, 4.2), paediatric ward (RR 1.8; 95% CI 1.2, 2.7), obstetric ward (RR 2.5; 95% CI 2.0, 3.1), gynaecological ward (RR 2.1; 95% CI 1.5, 2.9), orthopaedics ward (RR 3.8; 95% CI 2.2, 6.7). Age of the patient, pallor and confirmation of pre-transfusion haemoglobin level were also significantly associated with inappropriate requisition. Majority of appropriate requisitions within the wards were marked in internal medicine (91.7%) and gynaecological wards (77.8%). Conclusions The proportion of inappropriate blood requests was high. Blood requisition was determined by clinical and laboratory findings and the ward patients were admitted to. Adherence to transfusion guidelines is recommended to assure the best use of limited blood supply.

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author
; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
in
PLoS ONE
volume
13
issue
5
article number
e0196453
pages
1 - 16
publisher
Public Library of Science (PLoS)
external identifiers
  • scopus:85047395924
  • pmid:29771998
ISSN
1932-6203
DOI
10.1371/journal.pone.0196453
language
English
LU publication?
no
additional info
Publisher Copyright: © 2018 Mauka et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
id
a96577a3-cd0b-4bd6-80fb-64cba23d9aa0
date added to LUP
2022-09-29 10:08:40
date last changed
2024-06-13 19:48:02
@article{a96577a3-cd0b-4bd6-80fb-64cba23d9aa0,
  abstract     = {{<p>Background Blood is a critical aspect of treatment in life saving situations, increasing demand. Blood requisition practices greatly effect sufficient supply in blood banks. This study aimed to determine the risk factors for inappropriate blood requisition in Tanzania. Methods This was a cross sectional study using secondary data of 14,460 patients’ blood requests from 42 transfusion hospitals. Primary data were obtained by using cluster-sampling design. Data were analysed using a two-level mixed-effects Poisson regression to determine fixed-effects of individual-level factors and hospital level factors associated with inappropriate blood requests. P-value &lt;0.05 (2-tails) was considered statistically significant. Results Inappropriate requisition was 28.8%. Factors significantly associated with inappropriate requisition were; reporting pulse rate and capillary refill decrease the risk (RR 0.74; 95% CI 0.64, 0.84) and (RR 0.73; 95% CI 0.63, 0.85) respectively and the following increased the risk; having surgery during hospital stay (RR 1.22; 95% CI 1.06, 1.4); being in general surgical ward (RR 3.3; 95% CI 2.7, 4.2), paediatric ward (RR 1.8; 95% CI 1.2, 2.7), obstetric ward (RR 2.5; 95% CI 2.0, 3.1), gynaecological ward (RR 2.1; 95% CI 1.5, 2.9), orthopaedics ward (RR 3.8; 95% CI 2.2, 6.7). Age of the patient, pallor and confirmation of pre-transfusion haemoglobin level were also significantly associated with inappropriate requisition. Majority of appropriate requisitions within the wards were marked in internal medicine (91.7%) and gynaecological wards (77.8%). Conclusions The proportion of inappropriate blood requests was high. Blood requisition was determined by clinical and laboratory findings and the ward patients were admitted to. Adherence to transfusion guidelines is recommended to assure the best use of limited blood supply.</p>}},
  author       = {{Mauka, Wilhellmuss I. and Mtuy, Tara B. and Mahande, Michael J. and Msuya, Sia E. and Mboya, Innocent B. and Juma, Abdul and Philemon, Rune N.}},
  issn         = {{1932-6203}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{1--16}},
  publisher    = {{Public Library of Science (PLoS)}},
  series       = {{PLoS ONE}},
  title        = {{Risk factors for inappropriate blood requisition among hospitals in Tanzania}},
  url          = {{http://dx.doi.org/10.1371/journal.pone.0196453}},
  doi          = {{10.1371/journal.pone.0196453}},
  volume       = {{13}},
  year         = {{2018}},
}