An Audit on Overnight Transfusion Practice in A Teaching Hospital in Malaysia

Yee Loong Tang, R. Yousuf, W. M. Wan Nawawi, I. L. Rahman, J. Zainal Abidin, V. R. Rechard Nathan, C. F. Leong

Research output: Contribution to journalArticle

Abstract

INTRODUCTION: Overnight transfusion (OT) is the blood transfusion taking place from 9pm to 8am. During this period, patients are exposed to increased risk of errors. This cross-sectional study aims to determine the incidence and practice of OT in Universiti Kebangsaan Malaysia Medical Centre. MATERIALS & METHODS: Data from all OT in June and mid-July 2017 were collected from recipients' cards, transfusion request forms and patient's case files, regarding discipline involved, indications, time intervals from request of blood transfusion to the completion of OT on patients, monitoring of patients and adverse reactions. RESULTS: A total of 1285 transfusion cases were identified during the study period. 216 (16.8%) cases were OT while the 1069 (83.2%) cases were non-OT. Surgery discipline has the highest (30.1%) OT. The indications of OT were acute clinical need: 82.9%, less acute clinical need: 13.9% and no clinical need: 3.2%. A huge delay (average: 5 hours 40 minutes) in starting transfusion after grouping and crossmatching (GXM) completion was noted. Besides, 25.9% cases took <4 hours to complete OT; 83.4% cases did not have proper transfusion monitoring and three transfusion reactions were reported. DISCUSSION: Although most of the OT cases had appropriate clinical indications, the transfusion can be commenced earlier at day time rather than overnight. Cases without absolute indication should avoid OT. The poor monitoring of patient during OT had posed risks to patients' life if an adverse transfusion reaction happened. The major reason for OTs was a huge delay in starting transfusion after the GXM completion. The contravention of 4-hour infusion rule increased the patients' risk of developing bacterial sepsis. The practice of OT should be discouraged wherever possible except for clinically indicated cases.

Original languageEnglish
Pages (from-to)161-167
Number of pages7
JournalThe Malaysian journal of pathology
Volume41
Issue number2
Publication statusPublished - 1 Aug 2019

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Malaysia
Teaching Hospitals
Physiologic Monitoring
Blood Transfusion
Sepsis
Cross-Sectional Studies
Incidence
Transfusion Reaction

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology
  • Cell Biology

Cite this

Tang, Y. L., Yousuf, R., Wan Nawawi, W. M., Rahman, I. L., Zainal Abidin, J., Rechard Nathan, V. R., & Leong, C. F. (2019). An Audit on Overnight Transfusion Practice in A Teaching Hospital in Malaysia. The Malaysian journal of pathology, 41(2), 161-167.

An Audit on Overnight Transfusion Practice in A Teaching Hospital in Malaysia. / Tang, Yee Loong; Yousuf, R.; Wan Nawawi, W. M.; Rahman, I. L.; Zainal Abidin, J.; Rechard Nathan, V. R.; Leong, C. F.

In: The Malaysian journal of pathology, Vol. 41, No. 2, 01.08.2019, p. 161-167.

Research output: Contribution to journalArticle

Tang, YL, Yousuf, R, Wan Nawawi, WM, Rahman, IL, Zainal Abidin, J, Rechard Nathan, VR & Leong, CF 2019, 'An Audit on Overnight Transfusion Practice in A Teaching Hospital in Malaysia', The Malaysian journal of pathology, vol. 41, no. 2, pp. 161-167.
Tang YL, Yousuf R, Wan Nawawi WM, Rahman IL, Zainal Abidin J, Rechard Nathan VR et al. An Audit on Overnight Transfusion Practice in A Teaching Hospital in Malaysia. The Malaysian journal of pathology. 2019 Aug 1;41(2):161-167.
Tang, Yee Loong ; Yousuf, R. ; Wan Nawawi, W. M. ; Rahman, I. L. ; Zainal Abidin, J. ; Rechard Nathan, V. R. ; Leong, C. F. / An Audit on Overnight Transfusion Practice in A Teaching Hospital in Malaysia. In: The Malaysian journal of pathology. 2019 ; Vol. 41, No. 2. pp. 161-167.
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