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- Title
Massive Transfusion Protocol Adherence: Relationship to Trauma Patient Outcomes.
- Authors
Margolin, Alexander M.; Silva, Susan G.; McLaughlin, Kasey E. T.; Pereira, Katherine C.; Flowe, Adam M.; Poisson, Jessica L.
- Abstract
BACKGROUND: Ongoing evaluation of massive transfusion protocol adherence is critical to ensure better trauma patient outcomes. OBJECTIVE: This quality improvement initiative aimed to determine provider adherence to a recently revised massive transfusion protocol and its relationship to clinical outcomes among trauma patients requiring massive transfusion. METHODS: A retrospective, descriptive, correlational design was used to determine the association between provider adherence to a recently revised massive transfusion protocol and clinical outcomes in trauma patients with hemorrhage treated at a Level I trauma center from November 2018 to October 2020. Patient characteristics, provider massive transfusion protocol adherence, and patient outcomes were assessed. Patient characteristics and massive transfusion protocol adherence associations with 24-hr survival and survival to discharge were determined using bivariate statistical methods. RESULTS: A total of 95 trauma patients with massive transfusion protocol activation were evaluated. Of the 95, 71 (75%) survived the initial 24 hr following massive transfusion protocol activation and 65 (68%) survived to discharge. Based on protocol applicable items, the median massive transfusion protocol overall adherence rate per patient was 75% (IQR = 57.1–85.7) for the 65 survivors and 25% (IQR = 12.5–50.0) for the 21 nonsurvivors to discharge whose death occurred at least 1 hr after massive transfusion protocol activation (p <.001). CONCLUSION: Findings indicate the importance of ongoing evaluations of adherence to massive transfusion protocols in hospital trauma settings to target areas for improvement.
- Subjects
RESEARCH; STATISTICS; INTENSIVE care units; LENGTH of stay in hospitals; PENETRATING wounds; HEMOGLOBINS; BLOOD transfusion; RESEARCH methodology; TRAUMA centers; BLOOD platelets; PATIENTS; RETROSPECTIVE studies; MANN Whitney U Test; MEDICAL protocols; TREATMENT effectiveness; QUALITY assurance; EMERGENCY medical services; DESCRIPTIVE statistics; CHI-squared test; GLASGOW Coma Scale; STATISTICAL correlation; ELECTRONIC health records; DATA analysis; DATA analysis software; HEMORRHAGE; OVERALL survival; EVALUATION
- Publication
Journal of Trauma Nursing, 2023, Vol 30, Issue 3, p164
- ISSN
1078-7496
- Publication type
Article
- DOI
10.1097/jtn.0000000000000722