Cargando…
Doctors’ practice and attitudes towards red blood cell transfusion at Mthatha Regional Hospital, Eastern Cape, South Africa: A mixed methods study
BACKGROUND: Unnecessary blood transfusion exposes recipients to potential harms. AIM: The aim of this study was to describe blood transfusion practice and explore doctors’ attitudes towards transfusion. SETTING: A hospital providing level 1 and 2 services. METHODS: A mixed-methods study design was u...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AOSIS
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8252156/ https://www.ncbi.nlm.nih.gov/pubmed/34212740 http://dx.doi.org/10.4102/phcfm.v13i1.2889 |
_version_ | 1783717241805602816 |
---|---|
author | Adedayo, Temitope O’Mahony, Don Adeleke, Olukayode Mabunda, Sikhumbuzo |
author_facet | Adedayo, Temitope O’Mahony, Don Adeleke, Olukayode Mabunda, Sikhumbuzo |
author_sort | Adedayo, Temitope |
collection | PubMed |
description | BACKGROUND: Unnecessary blood transfusion exposes recipients to potential harms. AIM: The aim of this study was to describe blood transfusion practice and explore doctors’ attitudes towards transfusion. SETTING: A hospital providing level 1 and 2 services. METHODS: A mixed-methods study design was used. In the cross-sectional descriptive component, a sample was taken from patients transfused over a 2-month period. Blood use was categorised as for medical anaemia or haemorrhage, and appropriate or not. The qualitative component comprised a purposeful sample for focus group and individual semi-structured interviews. RESULTS: Of 239 patients sampled, 62% were transfused for medical anaemia and 38% for haemorrhage. In the medical anaemia group, compliance with age-appropriate transfusion thresholds was 69%. In medical anaemia and haemorrhage, 114 (77%) and 85 (93.4%) of recipients had orders for ≥ 2 red blood cell (RBC) units, respectively. In adults ≥ 18 years old with medical anaemia, 47.1% of orders would have resulted in a haemoglobin (Hb) > 8 g/dL. Six doctors participated in focus group and eleven in individual interviews. There was a lack of awareness of institutional transfusion guidelines, disagreement on appropriate RBC transfusion thresholds and comments that more than one RBC unit should always be transfused. Factors informing decisions to transfuse included advice from senior colleagues, relieving symptoms of anaemia and high product costs. CONCLUSION: Most orders were for two or more units. In medical anaemia, doctors’ compliance with RBC transfusion thresholds was reasonable; however, almost half of the orders would have resulted in overtransfusion. The attitudes of doctors sampled suggest that their transfusion practice is influenced more by institutional values than formal guidelines. |
format | Online Article Text |
id | pubmed-8252156 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | AOSIS |
record_format | MEDLINE/PubMed |
spelling | pubmed-82521562021-07-02 Doctors’ practice and attitudes towards red blood cell transfusion at Mthatha Regional Hospital, Eastern Cape, South Africa: A mixed methods study Adedayo, Temitope O’Mahony, Don Adeleke, Olukayode Mabunda, Sikhumbuzo Afr J Prim Health Care Fam Med Original Research BACKGROUND: Unnecessary blood transfusion exposes recipients to potential harms. AIM: The aim of this study was to describe blood transfusion practice and explore doctors’ attitudes towards transfusion. SETTING: A hospital providing level 1 and 2 services. METHODS: A mixed-methods study design was used. In the cross-sectional descriptive component, a sample was taken from patients transfused over a 2-month period. Blood use was categorised as for medical anaemia or haemorrhage, and appropriate or not. The qualitative component comprised a purposeful sample for focus group and individual semi-structured interviews. RESULTS: Of 239 patients sampled, 62% were transfused for medical anaemia and 38% for haemorrhage. In the medical anaemia group, compliance with age-appropriate transfusion thresholds was 69%. In medical anaemia and haemorrhage, 114 (77%) and 85 (93.4%) of recipients had orders for ≥ 2 red blood cell (RBC) units, respectively. In adults ≥ 18 years old with medical anaemia, 47.1% of orders would have resulted in a haemoglobin (Hb) > 8 g/dL. Six doctors participated in focus group and eleven in individual interviews. There was a lack of awareness of institutional transfusion guidelines, disagreement on appropriate RBC transfusion thresholds and comments that more than one RBC unit should always be transfused. Factors informing decisions to transfuse included advice from senior colleagues, relieving symptoms of anaemia and high product costs. CONCLUSION: Most orders were for two or more units. In medical anaemia, doctors’ compliance with RBC transfusion thresholds was reasonable; however, almost half of the orders would have resulted in overtransfusion. The attitudes of doctors sampled suggest that their transfusion practice is influenced more by institutional values than formal guidelines. AOSIS 2021-06-24 /pmc/articles/PMC8252156/ /pubmed/34212740 http://dx.doi.org/10.4102/phcfm.v13i1.2889 Text en © 2021. The Authors https://creativecommons.org/licenses/by/4.0/Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License. |
spellingShingle | Original Research Adedayo, Temitope O’Mahony, Don Adeleke, Olukayode Mabunda, Sikhumbuzo Doctors’ practice and attitudes towards red blood cell transfusion at Mthatha Regional Hospital, Eastern Cape, South Africa: A mixed methods study |
title | Doctors’ practice and attitudes towards red blood cell transfusion at Mthatha Regional Hospital, Eastern Cape, South Africa: A mixed methods study |
title_full | Doctors’ practice and attitudes towards red blood cell transfusion at Mthatha Regional Hospital, Eastern Cape, South Africa: A mixed methods study |
title_fullStr | Doctors’ practice and attitudes towards red blood cell transfusion at Mthatha Regional Hospital, Eastern Cape, South Africa: A mixed methods study |
title_full_unstemmed | Doctors’ practice and attitudes towards red blood cell transfusion at Mthatha Regional Hospital, Eastern Cape, South Africa: A mixed methods study |
title_short | Doctors’ practice and attitudes towards red blood cell transfusion at Mthatha Regional Hospital, Eastern Cape, South Africa: A mixed methods study |
title_sort | doctors’ practice and attitudes towards red blood cell transfusion at mthatha regional hospital, eastern cape, south africa: a mixed methods study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8252156/ https://www.ncbi.nlm.nih.gov/pubmed/34212740 http://dx.doi.org/10.4102/phcfm.v13i1.2889 |
work_keys_str_mv | AT adedayotemitope doctorspracticeandattitudestowardsredbloodcelltransfusionatmthatharegionalhospitaleasterncapesouthafricaamixedmethodsstudy AT omahonydon doctorspracticeandattitudestowardsredbloodcelltransfusionatmthatharegionalhospitaleasterncapesouthafricaamixedmethodsstudy AT adelekeolukayode doctorspracticeandattitudestowardsredbloodcelltransfusionatmthatharegionalhospitaleasterncapesouthafricaamixedmethodsstudy AT mabundasikhumbuzo doctorspracticeandattitudestowardsredbloodcelltransfusionatmthatharegionalhospitaleasterncapesouthafricaamixedmethodsstudy |