Blood shortage situation: An audit of red blood cells order and pattern of utilization

The objective of this work is to audit blood utilization by different specialties in the hospital using the Cross-match ratio as a guide to achieving effective transfusion practices. This was a prospective study.The blood bank of University Teaching Hospital in Benin City, Nigeria was used for the study. We analysed all blood orders from January to December, 2008. Data collection included number of units ofred blood cells ordered and the origin of the orders, the actual numbers of units transfused and points of use. A total of 8988 units of red blood cells were available but 19147 cross-matches (units) were ordered for 3067 patients, representing approximately 6 cross-match per patients and the mean crossmatch/ transfusion ratio of 2.2 (19147/8988). Cross-match/transfusion ratio for various departments/units were: Medicine 1.8; Paediatrics 2.6; Obstetrics and Gynaecology 1.6; Surgery /Orthopaedics 3.3; Accident and Emergency 3.3 and Theatres 1 and the probability that cross-matched blood might not be used were 43, 61, 39, 70, 0 and 58%, respectively. Cost implication of unnecessary cross-match was 7,879,500:00 Nigeria Naira (69,118.42 United States Dollar) per annum with surgical units accounting for nearly 3,000,000:00 Nigeria Naira (26,315.9 United States Dollar) for the period of the study. Crossmatch orders and C/T ratio vary from one department or unit to another. The unnecessary cross-match has financial and personnel implications on transfusion service in the hospital. It may be clinically prudent to streamline transfusion and cross-match orders so as to ensure the best transfusion practices